Description: Segment 1 An unidentified patient is shown with a gauze mask covering their face whilst ether is dropped on to it. The narrator explains that it is a difficult anaesthetic to give really well. Intertitle: Essential apparatus. A medicine bottle and dropper are shown and then how to prepare a cork to use as a dropper. The exact construction of the mask is demonstrated with layers of gauze. Vaseline for lubrication as well as airways, a tube with a safety pin to secure it and other surgical accessories are then identified. Intertitle: Premedication. In preparation for the anaesthetic, the patient is rested for 24 hours in bed, given no food for 4 hours or drinks for 2. Enemas are mentioned as unnecessary. To illustrate this a female patient is prepared for surgery. She is administered morphine and atrophine. This is timed and added to her chart. Within 45 minutes the patient will be ready and the nurse closes the curtains. Fade to black. Time start: 00:00:00:00 Time end: 00:05:32:13 Length: 00:05:32:13 Segment 2 Intertitle Course of anaesthesia. The narrator emphasises the importance of checking the patient's record, speaking to the patient and providing reassurance, having a good bedside manner, so that the patient co-operates, especially when nervous. The anaethetist is encouraged to check the patient for loose teeth or dental plates. Scrolling text reminds the practioner of the four stages of anaesthesia. Boldened intertitle: THE FIRST STAGE. A gamgee (wadding), then the mask is placed over the patient's face. The anaethetist briefly smells the ether and then places a few drops on the gauze, a little at a time. If this is done too quickly, the patient will cough and the mask has to be removed temporarily. The ether is then poured on, but not so that it completely soaks it. Time start: 00:05:32:13 Time end: 00:08:51:01 Length: 00:03:19:12 Segment 3 Intertitle: THE SECOND STAGE. It is noted that observation of the breath is very important the first stage taking 10 minutes to reach complete unconsciousness. For the purposes of the demonstration the patient's eyes are shown (viewers are reminded not to try this in case the patient is disturbed). The pupils are small and the eyes move from side to side. A nasal tube is inserted and ether is continually administered. Intertitle THE THIRD STAGE. After 5 minutes there is a change to regular automatic breathing. The patient's eyes are fixed and central. The jaw is relaxed and an artificial airway can be inserted. The chin is positioned. The anaethetist monitors the pulse manually. More ether is applied. Anaesthesia becomes deeper, the muscles weaken and the breathing is seen to originate from the diaphragm in a seesaw movement. During surgery, the anaesthetist has to keep his hand under the towels to monitor the breath. There is a short scene to illustrate this. It is noted that ether is a poison and it takes experience to gauge the correct dosage. The eyes of a patient undergoing gastric surgery are shown they are eccentric with small pupils, indicating light anaesthesia. This is deepened as the surgery continues. However, for the beginner or occasional anaesthetist, it is noted that continuous deep anaesthesia is desirable. Time start: 00:08:51:01 Time end: 00:15:39:06 Length: 00:06:48:05 Segment 4 Intertitle: Pitfalls of ether anaesthesia. Rolling titles explain the pitfalls for the inexperienced anaesthetist, they are described as a comedy of errors. Intertitle: 1. The first stage. Firstly the anaesthetist hasn't stoppered the ether securely and so the agent spills out over his hands, luckily not over the patient. Ether is dropped too rapidly onto the mask and the patient panics and chokes. Next the patient starts struggling, even though unconscious (apparently common in nervous patients). Ether is continuously applied. Intertitle: 2. Struggling in the second stage. The patient is unconscious but not fully anaesthetised. The patient is physically restrained by attendants. Stops abruptly. Time start: 00:15:39:06 Time end: 00:18:13:00 Length: 00:02:24:06