Description: Segment 1 A female patient is anaesthetised using the inhalation method. The narrator explains that the information in this film is relevant to anaesthesia with either nitrous oxide or ether. Narration runs in parallel with the separate stages of anaesthesia shown using Guedel's chart. The chart is animated. The first stage starts with the first breath of anaesthetic vapour and the beginning of the loss of consciousness. The second stage is characterised by the complete lack of consciousness (it is sometimes called the stage of delirium). The patient becomes unresponsive to painful stimuli. The third stage is true surgical anaesthesia. The third stage is in turn sub-divided into four planes light, moderate, deep and very deep anaesthesia. Below the fourth plane of the third stage of anaesthesia is the fourth stage, impending respiratory failure and death from overdose. Intertitle: explaination of the importance of observing reflexes. Guedel's chart is shown animated with symbols depicting diaphragmatic and thoracic movement. This is repeated in more detail explaining how the breath combines with movement. Time start: 00:00:00:00 Time end: 00:07:33:22 Length: 00:07:33:22 Segment 2 The Guedel chart is further annotated by other reflexes firstly the laryngeal reflex, then the salivation and mucus production reflex, then reflex vomiting. A male patient is shown in order to illustrate the respiratory reflexes throughout the stages of anaesthesia. The point-of-view of the anaesthetist is seen as he observes chest movement and the anaesthetic breathing bag. The breath becomes shallow and it is observed that the patient is about to vomit as he reacts to the irritant effect of the ether. The narrator warns about the laryngeal reflex. The patient then moves from the second to the third stage of anaesthesia. The nature of the breath is explained it is closer to normal sleep. The other reflexes are present. The patient appears to spasm. The third plane of the third stage is shown the naked torso of a male patient is shown. During surgery, where the patient is covered, the anaesthetist is advised to place his hand on the chest under the towels or observe the abdomen. Time start: 00:07:33:22 Time end: 00:12:09:20 Length: 00:04:27:18 Segment 3 The Guedel chart is consulted once again in the fourth plane of the third stage of anaesthesia the breathing is shallow and jerkier, characterised by a seesaw movement. A patient is shown. In the fourth stage the breathing becomes even shallower the anaesthesia needs to be withdrawn before cyanosis occurs (caused by a build-up of carbon-dioxide). Intertitle: Explaination of the reflexes which indicate the depth of anaesthesia the eyes. Time start: 00:12:09:20 Time end: 00:15:39:06 Length: 00:03:29:11 Segment 4 The lash and congunctival reflexes are demonstrated. Then the corneal reflex is shown. The Guedel chart is annotated accordingly. Next the position of the eyes are demonstrated (either movement or divergent). The Guedel chart is once again annotated. Next the size of the pupils and their reaction to light are shown. For the purposes of the demonstration, the eyes are photographed in darkness using infra-red rays. A light then is shined onto the eyes showing exaggerated dilation at each stage of anaesthesia the pupils are larger than in real life. The Guedel chart is annotated once again with all these reflexes. The anaesthesetist is reminded that premedication can effect the size of the pupils. Intertitle: Explaination that the practioner needs to know what is happening to the patient. In summary, breathing is the most important an operation is in progress with an anaesthetist in attendance. A female patient is then shown vomiting to illustrate that it is important to note each observable sign and any changes. Premedication is shown with a reminder of its effect on the eyereflexes. ICI. The End. Time start: 00:15:39:06 Time end: 00:21:39:00 Length: 00:06:00:06