Table Of ContentWARD’S
ANAESTHETIC
EQUIPMENT
Commissioning Editor: Timothy Horne / Jeremy Bowes
Development Editor: Ailsa Laing
Project Manager: Beula Christopher
Illustrations Manager: Gillian Richards
Designer: Charles Gray
WARD’S
ANAESTHETIC
SIXTH
EDITION EQUIPMENT
Edited by
Andrew J Davey LRCP and SI FRCA
Consultant Anaesthetist, Sussex Orthopaedic NHS Treatment Centre, West Sussex, UK
Ali Diba BM FRCA
Consultant Anaesthetist, Queen Victoria Hospital, East Grinstead, UK
Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2012
© 2012 Elsevier Ltd. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, or any information storage and retrieval system, without permission in writing from
the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our
arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found
at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as
may be noted herein).
First edition 1975
Second edition 1985
Third edition 1992
Fourth edition 1998
Fifth edition 2005
ISBN 978-0-7020-3094-9
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understand-
ing, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any informa-
tion, methods, compounds, or experiments described herein. In using such information or methods they should be mindful
of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information
provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recom-
mended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of
practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages
and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any
injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or
operation of any methods, products, instructions, or ideas contained in the material herein.
The
Working together to grow
publisher’s
libraries in developing countries policy is to use
paper manufactured
from sustainable forests
www.elsevier.com | www.bookaid.org | www.sabre.org
Printed in China
Contents
Contents
Contributors .....................................................vii 10. Ventilation in the intensive
Preface ................................................................ix care unit .................................................253
Acknowledgments ..............................................x Martin Street
Dedication .........................................................xi 11. Breathing filters, humidifiers
Abbreviations ...................................................xii and nebulizers .......................................275
Antony R Wilkes
1. The supply of anaesthetic and other 12. Equipment for paediatric
medical gasses ............................................1 anaesthesia .............................................289
Hubert Bland, Carrie Borton and Stephen Fenlon
Syed Jafri 13. Equipment for regional
2. Measurement of pressure and anaesthesia ..............................................311
gas flow .....................................................27 Susanne Krone
Paul Beatty 14. Physiological monitoring: principles
3. Vaporizers .................................................41 and non-invasive monitoring ...............323
Andrew J Davey Patrick T Magee
4. The anaesthetic workstation ...................65 15. Physiological monitoring: gasses ..........337
Ali Diba Patrick T Magee
5. Breathing systems and their 16. Cardiac output monitoring ...................351
components ...........................................107 Robert Sekun Kong and
Andrew J Davey Luigi Vetrugno
6. Airway management equipment ..........139 17. Depth of anaesthesia and
Tim Cook neurophysiological monitoring ...........369
7. Equipment for the inhalation of Andrew Morley and Gustav Strandvik
oxygen and other gasses ........................207 18. Atmospheric pollution ..........................385
Thomas DA Standley and Sarah Bailey
Daniel W Wheeler 19. Infusion equipment and
8. Manual resuscitators .............................225 intravenous anaesthesia ........................399
Andrew J Davey Ali Diba
9. Automatic ventilators ............................231 20. Medical suction apparatus ....................421
Andrew J Davey Andrew J Davey
v
Contents
21. Cleaning, disinfection and 28. The anaesthetist and the Medicines
sterilization.............................................429 and Healthcare products Regulatory
Trevor A King and Richard PD Cooke Agency ....................................................493
22. Information technology and Stephen Fenlon
the anaesthetic workstation ..................439 29. Error, Man and Machine .......................503
Chris J Barham Sally E Rampersad and
23. Electrical hazards and Carlyle (Jai) Rampersad
their prevention .....................................447 30. Warming devices ....................................513
Patrick T Magee C Mark Harper
24. Surgical diathermy .................................459 31. Physics and technology of
Patrick T Magee ultrasound ..............................................525
25. Pacemakers and defibrillators ..............465 Crispian P Oates
Nicholas P Gall
Appendix
26. Lasers ......................................................475
SI units and conversion tables ......................541
Patrick T Magee
Chetan Patel
27. Provision of anaesthesia in difficult
situations and the developing world ...479
Index ...............................................................547
Deborah Harris and John A Carter
vi
Contributors
Contributors
Sarah Bailey MBBS, FRCA Richard PD Cooke FRCP, FRCPath, Dip, HIC
Specialist Registrar Consultant Medical Microbiologist
Queen Victoria Hospital Department of Clinical Microbiology
East Grinstead, UK University Hospital Aintree
Liverpool, UK
Chris J Barham MBBS, FRCA
Consultant Anaesthetist Andrew J Davey LRCP and SI FRCA
Queen Victoria Hospital Consultant Anaesthetist
East Grinstead, UK Sussex Orthopaedic NHS Treatment Centre
West Sussex, UK
Paul Beatty BSc, MSc, PhD, CEng, FIPEM
Senior Lecturer in Biomedical Engineering Ali Diba BM, FRCA
Imaging Science and Biomedical Engineering Consultant Anaesthetist
The University of Manchester Queen Victoria Hospital
Manchester, UK East Grinstead, UK
Hubert Bland MBChB Stephen Fenlon BM, BS, FRCA
Chief Medical Officer Consultant Anaesthetist
Surrey Clinical Research Centre and Surrey Queen Victoria Hospital
Human Performance Institute East Grinstead, UK
Division of Clinical Medicine
Faculty of Health and Medical Sciences Nicholas P Gall MSc, MD, MRCP, NASPExAM, Testamur
University of Surrey Consultant Cardiologist and Cardiac Electrophysiologist
Surrey, UK King’s College Hospital
And Honorary Senior Lecturer
Carrie Borton BSc King’s College London
Global Regulatory Affairs Specialist London, UK
Linde Healthcare
Surrey, UK C Mark Harper BSc, MBBS, FRCA
Consultant Anaesthetist
John A Carter MBBS, FRCA Brighton and Sussex University Hospitals
Consultant in Anaesthesia and Intensive Care Medicine Brighton, UK
Frenchay Hospital
Bristol, UK Deborah Harris LMS, FRCA
Consultant in Anaesthesia and Intensive Care Medicine
Tim Cook BA, MBBS, FRCA Frenchay Hospital
Consultant in Anaesthesia and Intensive Care Bristol, UK
Royal United Hospital
Bath, UK
vii
Contributors
Syed Jafri MBBS, MRCS, FRCR, MBA Carlyle (Jai) Rampersad BS, ATP
Clinical Specialist Captain, Airbus A310
Linde Healthcare US Airways, USA
Surrey, UK
Sally E Rampersad MB, DCH, FRCA
Trevor A King FRCA Attending Anesthesiologist
Consultant Anaesthetist Seattle Children’s Hospital
East Sussex Hospitals NHS Trust Seattle, USA
Eastbourne, UK
Thomas DA Standley MB, ChB, FRCA, EDIC
Robert Sekun Kong MBBS, FRCA, EDIC Consultant in Anaesthesia / Intensive Care
Consultant Cardiac Anaesthetist Western Sussex Hospitals NHS Trust
Royal Sussex County Hospital West Sussex, UK
Brighton, UK
Gustav Strandvik MBChB, MRCP, FRCA, DICM(UK)
Susanne Krone FRCA Consultant Anaesthetist and Intensive Care Physician
Consultant Anaesthetist Kent and Canterbury Hospital
Queen Victoria Hospital Canterbury, UK
East Grinstead, UK
Martin Street FJFICM
Patrick T Magee MSc, FRCA, MIEE, AMI, MechE Consultant Intensivist
Consultant in Anaesthesia Department of Intensive Care
Royal United Hospital, Bath; Royal Sussex County Hospital
and Visiting Senior Lecturer Brighton, UK
Department of Mechanical Engineering
University of Bath Luigi Vetrugno MD
Bath, UK Consultant in Anesthesia and Intensive Care Medicine
University of Udine
Andrew Morley FRCA Udine, Italy
Consultant Anaesthetist
Guy’s and St Thomas’ Hospitals Daniel W Wheeler MA, DM, PhD, MRCP, FRCA
London, UK Lecturer in Anaesthesia and Honorary Consultant
Anaesthetist
Crispian P Oates MSc, BSc, MIPEM, AVS University Department of Anaesthesia
Head of Regional Vascular Ultrasound University of Cambridge
Regional Medical Physics Department Cambridge, UK
Freeman Hospital
Newcastle Upon Tyne, UK Antony R Wilkes PhD, MSc, BSc
Senior Research Fellow
Chetan Patel MBBS, FRCA Department of Anaesthetics and Intensive Care Medicine
Consultant Anaesthetist Wales College of Medicine
Queen Victoria Hospital Cardiff University
East Grinstead, UK Cardiff, UK
viii
