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 i

Essentials of
Anaesthetic Equipment
FOURTH EDITION
Senior Content Strategist: Jeremy Bowes
Content Development Specialist: Clive Hewat
Senior Project Manager: Beula Christopher
Designer: Miles Hitchens
Illustration Manager: Jennifer Rose
Illustrator: Richard Tibbits
 iii

Essentials of
Anaesthetic
Equipment
FOURTH EDITION

Baha Al-Shaikh FCARCSI, FRCA

Consultant Anaesthetist, William Harvey Hospital, Ashford, Kent, UK
Honorary Senior Lecturer, King’s College London, University of London, UK
Visiting Professor, Canterbury Christ Church University, UK

Simon Stacey FRCA

Consultant Anaesthetist, Barts and The London NHS Trust, London, UK

Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2013
© 2013 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 1995

Second edition 2002
Third edition 2007

ISBN: 978-0-7020-4954-5

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 understanding, 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 information, 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 recommended 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.

Working together to grow

libraries in developing countries
www.elsevier.com | www.bookaid.org | www.sabre.org

The
publisher’s
policy is to use
paper manufactured
from sustainable forests

Printed in China
 Contents

Preface vii Chapter 8 Appendix A

Acknowledgements ix VENTILATORS 121 CHECKING ANAESTHETIC
EQUIPMENT 256
Chapter 1 Chapter 9
MEDICAL GAS SUPPLY 1 HUMIDIFICATION AND Appendix B
FILTRATION 135 RECOMMENDATIONS FOR
Chapter 2
STANDARDS OF MONITORING
THE ANAESTHETIC MACHINE 19 Chapter 10 DURING ANAESTHESIA
NON-INVASIVE MONITORING 145 AND RECOVERY 258
Chapter 3
POLLUTION IN THEATRE AND Chapter 11 Appendix C
SCAVENGING 45 INVASIVE MONITORING 177 GRAPHICAL SYMBOLS FOR USE
IN LABELLING MEDICAL
Chapter 4 Chapter 12 DEVICES 263
BREATHING SYSTEMS 55 PAIN MANAGEMENT AND
REGIONAL ANAESTHESIA 201 Appendix D
Chapter 5
DECONTAMINATION OF MEDICAL
TRACHEAL AND TRACHEOSTOMY Chapter 13 EQUIPMENT 265
TUBES AND AIRWAYS 75 ADDITIONAL EQUIPMENT
USED IN ANAESTHESIA Appendix E
Chapter 6
AND INTENSIVE CARE 219 LATEX ALLERGY 269
MASKS AND OXYGEN DELIVERY
DEVICES 99 Chapter 14 Appendix F
ELECTRICAL SAFETY 241 DIRECTORY OF
Chapter 7
MANUFACTURERS 271
LARYNGOSCOPES AND TRACHEAL
INTUBATION EQUIPMENT 111 Glossary 275

Index 279
This page intentionally left blank
 Preface

Over 20 years ago, we conspired to write our colour equipment textbook ‘Essentials of Anaesthetic Equipment’. It is
now in its fourth edition and hopefully as relevant to anaesthetic practice as ever.
We have tried to keep the book concise, however due to the sheer number of new anaesthetic equipment products
used in the clinical practice today, the size of the book has increased slightly. We have tried to freshen up the
photography/diagrams wherever possible. The text has been updated too and single best answer questions have
been included.
We hope this book will continue to be the equipment book of choice for both the trainees sitting FRCA exams and
their trainers and a useful reference tool for our Nursing and Operating Department Practitioner colleagues.

BA-S Ashford, Kent

SGS London
2013
This page intentionally left blank
 Acknowledgements

We are extremely grateful to the many manufacturers and others who have supplied the necessary information and
images for this edition. Without their help, this fourth edition could not have gone ahead in its current format.
Special mention goes to Andy Coughlan of Smiths Medical for his unflagging help with all things photographic.
Below is a list of the people and their companies who helped us by providing images during the preparation of
the book.
We are also grateful to the association of Anaesthetists of Great Britain and Ireland for granting permission to
reproduce their equipment checklist and monitoring recommendations.

Molly Bruton (Vygon) John van Kessel (B Braun) Ciska Proos (B Braun)

Tony Calvo (Olympus) Vanessa Light (Philips Health Care) Malcolm Pyke (Philips Heath Care)

Emma Christmas (Gambro) Sharon Maris (Teleflex) Siama Rafiq (BD Medical)

Andy Coughlan (Smith’s Medical) Lucy Martin-Davis (Verathon Emma Richardson (Argon Medical)
Medical)
Inga Dolezar (Chart BioMedical) Rachel Stein (I-Flow)
Anne Pattinson (Draeger)
Bjrake Frank-Duab (Radiometer) Frank Toal (B Braun)
Mark Pedley (Blue Box Medical)
Andrew Garnham (Penlon) Jill Garratt (Zoll Medical)
Lee Pettitt (Rimer Alco)
John Jones (MAQUET)
This page intentionally left blank
Chapter 1

Medical gas
supply
2 1 Medical gas supply

Gas supply
Medical gas supply takes the form
of either cylinders or a piped gas
system, depending on the
requirements of the hospital.

Cylinders
Components
1. Cylinders are made of thin-
walled seamless molybdenum
steel in which gases and vapours Fig. 1.1 Nitrous oxide cylinder with its Fig. 1.2 Oxygen cylinder valve and pin
wrapping and labels. index.
are stored under pressure. They
are designed to withstand
considerable internal pressure.
2. The top end of the cylinder is
called the neck, and this ends
in a tapered screw thread into
which the valve is fitted. The
thread is sealed with a material
that melts if the cylinder is
exposed to intense heat. This
allows the gas to escape so
reducing the risk of an
explosion.
3. There is a plastic disc around
the neck of the cylinder. The
year when the cylinder was last
examined can be identified from
the shape and colour of the disc.
4. Cylinders are manufactured in Fig. 1.3 Nitrous oxide cylinder valve and Fig. 1.4 Carbon dioxide cylinder valve
different sizes (A to J). Sizes A pin index. and pin index.
and H are not used for medical
gases. Cylinders attached to the a fibreglass covering in epoxy resonance scanners. They have a
anaesthetic machine are usually resin matrix. These can be used flat base to help in storage and
size E (Figs 1.1–1.4), while size J to provide oxygen at home, handling.
cylinders are commonly used during transport or in magnetic
for cylinder manifolds. Size E
oxygen cylinders contain 680 L,
whereas size E nitrous oxide ● Gas exits in the gaseous state at room temperature. Its liquefaction at
cylinders can release 1800 L. room temperature is impossible, since the room temperature is above its
The smallest sized cylinder, size critical temperature.
C, can hold 1.2 L of water, and ● Vapour is the gaseous state of a substance below its critical temperature. At
size E can hold 4.7 L while the room temperature and atmospheric pressure, the substance is liquid.
larger size J can hold 47.2 L of ● Critical temperature is the temperature above which a substance cannot be
water. liquefied no matter how much pressure is applied. The critical temperatures
5. Lightweight cylinders can be for nitrous oxide and oxygen are 36.5 and −118°C respectively.
made from aluminium alloy with
 Cylinders 3

Oxygen is stored as a gas at a

pressure of 13 700 kPa whereas Cylinders in use are checked and tested by manufacturers at regular intervals,
nitrous oxide is stored in a liquid usually 5 years. Test details are recorded on the plastic disc between the valve
phase with its vapour on top at a and the neck of the cylinder. They are also engraved on the cylinder:
pressure of 4400 kPa. As the liquid 1. Internal endoscopic examination.
is less compressible than the gas, 2. Flattening, bend and impact tests are carried out on at least one cylinder in
this means that the cylinder every 100.
should only be partially filled. The 3. Pressure test: the cylinder is subjected to high pressures of about 22 000 kPa,
amount of filling is called the filling which is more than 50% above their normal working pressure.
ratio. Partially filling the cylinders 4. Tensile test where strips of the cylinder are cut and stretched. This test is
with liquid minimizes the risk of carried out on at least one cylinder in every 100.
dangerous increases in pressure
with any increase in the ambient
temperature that can lead to an
explosion. In the UK, the filling
ratio for nitrous oxide and The marks engraved on the cylinders are:
carbon dioxide is 0.75. In hotter
climates, the filling ratio is 1. Test pressure.
reduced to 0.67. 2. Dates of test performed.
3. Chemical formula of the cylinder’s content.
4. Tare weight (weight of nitrous oxide cylinder when empty).
The filling ratio is the weight of
the fluid in the cylinder divided
by the weight of water required to
fill the cylinder.

Labelling
A full oxygen cylinder at The cylinder label includes the following details:
atmospheric pressure can deliver ● Name, chemical symbol, pharmaceutical form, specification of the product,
130 times its capacity of oxygen. A its licence number and the proportion of the constituent gases in a
typical size E full oxygen cylinder gas mixture.
delivering 4 L per minute will last ● Substance identification number and batch number.
for 2 hours and 50 minutes but ● Hazard warnings and safety instructions.
will last only 45 minutes when ● Cylinder size code.
delivering 15 L/min. ● Nominal cylinder contents (litres).
A full oxygen cylinder at ● Maximum cylinder pressure (bars).
atmospheric pressure can ● Filling date, shelf life and expiry date.
deliver 130 times its capacity of ● Directions for use.
oxygen. ● Storage and handling precautions.
At constant temperature, a
gas-containing cylinder shows a
linear and proportional reduction
in cylinder pressure as it empties.
Problems in practice and
For a cylinder that contains liquid a cylinder to the wrong yoke
safety features
and vapour, initially the pressure (Fig. 1.5).
remains constant as more vapour is 1. The gases and vapours should 3. Cylinders are colour-coded to
produced to replace that used. Once be free of water vapour when reduce accidental use of the
all the liquid has been evaporated, stored in cylinders. Water wrong gas or vapour. In the
the pressure in the cylinder vapour freezes and blocks the UK, the colour-coding is a
decreases. The temperature in such exit port when the temperature two-part colour, shoulder and
a cylinder can decrease because of of the cylinder decreases on body (Table 1.1). To improve
the loss of the latent heat of opening. safety, there are plans to
vaporization leading to the 2. The outlet valve uses the change the colours of the
formation of ice on the outside of pin-index system to make it bodies of cylinders using
the cylinder. almost impossible to connect medical gas to white while
4 1 Medical gas supply

5. Cylinders should be stored in

a purpose built, dry, well-
ventilated and fireproof room,
preferably inside and not
subjected to extremes of heat.
They should not be stored near
flammable materials such as oil
or grease or near any source of
heat. They should not be
exposed to continuous
dampness, corrosive chemicals
or fumes. This can lead to
corrosion of cylinders and their
valves.
6. To avoid accidents, full cylinders
should be stored separately from
empty ones. F, G and J size
cylinders are stored upright to
avoid damage to the valves. C,
D and E size cylinders can be
Fig. 1.5 Anaesthetic machine cylinder yokes. For the sake of comparison, the Bodok stored horizontally on shelves
seal is absent from the nitrous oxide yoke (left). made of a material that does not
damage the surface of the
keeping the colours of the 4. Cylinders should be checked cylinders.
shoulders according to the regularly while in use to ensure 7. Overpressurized cylinders are
European Standard EN that they have sufficient content hazardous and should be
1089-3. and that leaks do not occur. reported to the manufacturer.

Table 1.1 Colour coding of medical gas cylinders, their pressure when full and their physical state in the cylinder

Pressure, kPa Physical state

Body colour Shoulder colour (at room temperature) in cylinder

Oxygen Black (green in USA) White 13 700 Gas

Nitrous oxide Blue Blue 4400 Liquid/vapour
Carbon dioxide Grey Grey 5000 Liquid/vapour
Air Grey (yellow in USA) White/black quarters 13 700 Gas
Entonox Blue White/blue quarters 13 700 Gas
Oxygen/helium (Heliox) Black White/brown quarters 13 700 Gas

Oxygen

Nitrous oxide

Entonox
(50% N2O/50%O2)

Air

Carbon dioxide

Helium/oxygen mixture
(79% He/21% O2)
 Cylinder valves 5

Cylinders
● Cylinders are made of thin-
walled molybdenum steel to
withstand high pressures, e.g.
13 700 kPa and 4400 kPa for
Pin-index Side spindle Bullnose
oxygen and nitrous oxide valve pin-index valve
respectively. Lightweight valve
aluminium is also available.
● They are made in different sizes:
size E cylinders are used on the
anaesthetic machine; size J
cylinders are used in cylinder
banks.
● Oxygen cylinders contain gas
whereas nitrous oxide cylinders To Pin-index valve Star valve
contain a mixture of liquid and Valve types
vapour. In the UK, nitrous oxide Fig. 1.6 Chemical formula (N2O) Fig. 1.7 Cylinder valves.
cylinders are 75% filled with engraved on a nitrous oxide cylinder valve.
liquid nitrous oxide (filling ratio);
this is 67% in hotter climates.
● At a constant temperature, the
pressure in a gas cylinder
decreases linearly and
proportionally as it empties.
This is not true in cylinders
containing liquid/vapour.
● They are colour-coded (shoulder
and body).

Oxygen Nitrous Air Entonox

Cylinder valves oxide
Fig. 1.8 Pin-index system. Note the different configuration for each gas.
These valves seal the cylinder
contents. The chemical formula
of the particular gas is engraved 3. The exit port for supplying gas fitted in the yoke (Figs 1.8 and
on the valve (Fig. 1.6). Other types to the apparatus (e.g. anaesthetic 1.9). The gas exit port will not
of valves, the bull nose, the hand machine). seal against the washer of the
wheel and the star, are used 4. A safety relief device allows the yoke unless the pins and holes
under special circumstances discharge of cylinder contents to are aligned.
(Fig. 1.7). the atmosphere if the cylinder is 6. A more recent modification is
overpressurized. where the external part of the
5. The non-interchangeable safety valve is designed to allow
Components
system (pin-index system) is used manual turning on and off of
1. The valve is mounted on the top on cylinders of size E or smaller the cylinder without the need for
of the cylinder, screwed into the as well as on F- and G-size a key (Fig. 1.10).
neck via a threaded connection. Entonox cylinders. A specific pin
It is made of brass and configuration exists for each
sometimes chromium plated. medical gas on the yoke of the
Mechanism of action
2. An on/off spindle is used to anaesthetic machine. The
open and close the valve by matching configuration of holes 1. The cylinder valve acts as a
opposing a plastic facing against on the valve block allows only mechanism for opening and
the valve seating. the correct gas cylinder to be closing the gas pathway.
6 1 Medical gas supply

cylinder to the anaesthetic

machine. This clears particles of
dust, oil and grease from the
exit port, which would
otherwise enter the anaesthetic
machine.
2. The valve should be opened
slowly when attached to the
anaesthetic machine or
regulator. This prevents the
rapid rise in pressure and the
associated rise in temperature of
the gas in the machine’s
pipelines. The cylinder valve
should be fully open when in
use (the valve must be turned
two full revolutions).
3. During closure, overtightening
Fig. 1.9 A cylinder yoke and pin-index system. Note that a Bodok seal is in position.
of the valve should be avoided.
This might lead to damage to
the seal between the valve and
the cylinder neck.
4. The Bodok seal should be
inspected for damage prior to
use. Having a spare seal readily
available is advisable.

Cylinder valves
● They are mounted on the neck
of the cylinder.
● Act as an on/off device for the
discharge of cylinder contents.
● Pin-index system prevents
cylinder identification errors.
● Bodok sealing washer must be
placed between the valve and
the yoke of the anaesthetic
Fig. 1.10 New cylinder valve which allows manual opening and closing.
machine.
● A newly designed valve allows
2. A compressible yoke-sealing
keyless manual turning on and
washer (Bodok seal) must be
off.
placed between valve outlet and
the apparatus to make a
gas-tight joint (Fig. 1.11).

Problems in practice and

Piped gas supply
safety features (piped medical gas
1. The plastic wrapping of the and vacuum – PMGV)
valve should be removed just
before use. The valve should be PMGV is a system where gases are
slightly opened and closed delivered from central supply points
(cracked) before connecting the Fig. 1.11 A Bodok seal. to different sites in the hospital at a
 Piped gas supply (piped medical gas and vacuum – PMGV) 7

pressure of about 400 kPa. Special

outlet valves supply the various
needs throughout the hospital.
Oxygen, nitrous oxide, Entonox,
compressed air and medical vacuum
are commonly supplied through the
pipeline system.

Components
1. Central supply points such as
cylinder banks or liquid oxygen
storage tank.
2. Pipework made of special
high-quality copper alloy, which Fig. 1.12 Inserting a remote probe into its matching wall-mounted
outlet socket.
both prevents degradation of
the gases it contains and has
bacteriostatic properties. The
fittings used are made from
brass and are brazed rather than
soldered.
3. The size of the pipes differs
according to the demand that
they carry. Pipes with a 42 mm
diameter are usually used for
leaving the manifold. Smaller
diameter tubes, such as 15 mm,
are used after repeated branching.
4. Outlets are identified by gas Fig. 1.13 Gas probes for oxygen (top),
colour coding, gas name and by nitrous oxide (middle) and air (bottom).
shape (Fig. 1.12). They accept Note the locking groove on the probe to
matching quick connect/ ensure connectivity.
disconnect probes, Schrader pipeline network. They are also
sockets (Fig. 1.13), with an known as area valve service
indexing collar specific for each units (AVSUs) (Fig. 1.16). They
gas (or gas mixture). can be accessed to isolate the Fig. 1.14 Outlet sockets mounted in a
5. Outlets can be installed as supply to an area in cases of fire retractable ceiling unit. (Courtesy of
flush-fitting units, surface-fitting or other emergency Penlon Ltd, Abingdon, UK (www.penlon.
units, on booms or pendants, or com).)
suspended on a hose and gang
Problems in practice and
mounted (Fig. 1.14). 5. Anaesthetists are responsible for
safety features
6. Flexible colour-coded hoses the gases supplied from the
connect the outlets to the 1. A reserve bank of cylinders is terminal outlet through to the
anaesthetic machine (Fig. 1.15). available should the primary anaesthetic machine. Pharmacy,
The anaesthetic machine end supply fail. Low-pressure alarms supplies and engineering
should be permanently fixed detect gas supply failure departments share the
using a nut and liner union where (Fig. 1.17). responsibility for the gas
the thread is gas specific and 2. Single hose test is performed to pipelines ‘behind the wall’.
non-interchangeable (non- detect cross-connection. 6. There is a risk of fire from worn
interchangeable screw thread, 3. Tug test is performed to detect or damaged hoses that are
NIST, is the British Standard). misconnection. designed to carry gases under
7. Isolating valves behind break 4. Regulations for PMGV pressure from a primary source
glass covers are positioned at installation, repair and such as a cylinder or wall-
strategic points throughout the modification are enforced. mounted terminal to medical
8 1 Medical gas supply

devices such as ventilators and

anaesthetic machines. Because of
heavy wear and tear, the risk of
rupture is greatest in oxygen
hoses used with transport
devices. Regular inspection and
replacement, every 2–5 years, of
all medical gas hoses is
recommended.

Piped gas supply

● There is a network of copper alloy
pipelines throughout the hospital
from central supply points.
● The outlets are colour- and
shape-coded to accept matching
‘Schrader’ probes.
● Flexible and colour-coded

Fig. 1.15 Colour-coded hoses with NIST fittings attached to

pipelines run from the
an anaesthetic machine. anaesthetic machine to the
outlets.
● Single hose and tug tests are
performed to test for cross-
connection and misconnection
respectively.
● There is risk of fire from worn
and damaged hoses.

Sources of gas supply

The source of supply can be
cylinder manifold(s) and, in the case
of oxygen, a liquid oxygen storage
Fig. 1.16 An area valve service unit (AVSU). tank or oxygen concentrator
(Fig. 1.18).

CYLINDER MANIFOLD

Manifolds are used to supply

nitrous oxide, Entonox and oxygen.

Components
1. Large cylinders (e.g. size J each
with 6800 L capacity) are usually
divided into two equal groups,
primary and secondary. The two
groups alternate in supplying the
pipelines (Fig. 1.19). The number
Fig. 1.17 Medical gas alarm panel. (Courtesy of Penlon Ltd, of cylinders depends on the
Abingdon, UK (www.penlon.com).) expected demand.
 Sources of gas supply 9

Liquid oxygen

Fig. 1.18 Sources of oxygen supply in a hospital. A vacuum-insulated evaporator (left)

and a cylinder manifold (right).

LIQUID OXYGEN

A vacuum-insulated evaporator
(VIE) (Fig. 1.20) is the most
economical way to store and supply
oxygen.

Components
1. A thermally insulated double-
walled steel tank with a layer of
perlite in a vacuum is used as
the insulation (Fig. 1.21). It
can be described as a giant
thermos flask, employing the
same principles.
Fig. 1.19 An oxygen cylinder manifold. 2. A pressure regulator allows
gas to enter the pipelines
and maintains the pressure
2. All cylinders in each group are nearly empty. The changeover is through the pipelines at about
connected through non-return achieved through a pressure- 400 kPa.
valves to a common pipe. This sensitive device that detects when 3. A safety valve opens at
in turn is connected to the the cylinders are nearly empty. 1700 kPa allowing the gas to
pipeline through pressure 3. The changeover activates an escape when there is a build-up
regulators. electrical signalling system to of pressure within the vessel.
3. As nitrous oxide is only available alert staff to the need to change This can be caused by
in cylinders (in contrast to liquid the cylinders. underdemand for oxygen.
oxygen), its manifold is larger 4. A control valve opens when there
than that of oxygen. The latter Problems in practice and is an excessive demand on the
usually acts as a back up to liquid safety features system. This allows liquid oxygen
oxygen supply (see later). to evaporate by passing through
1. The manifold should be housed
in a well-ventilated room built of superheaters made of uninsulated
Mechanism of action coils of copper tubing.
fireproof material away from the
1. In either group, all the cylinders’ main buildings of the hospital.
valves are opened. This allows 2. The manifold room should not be
Mechanism of action
them to empty simultaneously. used as a general cylinder store.
2. The supply is automatically 3. All empty cylinders should be 1. Liquid oxygen is stored (up to
changed to the secondary group removed immediately from the 1500 L) at a temperature of
when the primary group is manifold room. −150° to −170°C (lower than
10 1 Medical gas supply

pressure at the bottom. By

measuring the difference in
pressure, the contents of the
VIE can be calculated. When
required, fresh supplies of
liquid oxygen are pumped
from a tanker into the vessel.
4. The cold oxygen gas is warmed
once outside the vessel in a coil
of copper tubing. The increase
in temperature causes an
increase in pressure.
5. At a temperature of 15°C and
atmospheric pressure, liquid
oxygen can give 842 times its
volume as gas.

Problems in practice and

safety features
Fig. 1.20 A vacuum-insulated evaporator (VIE). 1. Reserve banks of cylinders are
kept in case of supply failure.
2. A liquid oxygen storage vessel
7 bar Pressure regulator should be housed away from
main buildings due to the fire
Safety valve 4.1 bar
hazard. The risk of fire is
Temperature
approx. −160ºC
increased in cases of liquid
spillage.
3. Spillage of cryogenic liquid can
To pipeline cause cold burns, frostbite and
hypothermia.
Superheater
Vacuum
Control valve OXYGEN CONCENTRATORS
Pressure-raising vaporizer
Oxygen concentrators, also known
as pressure swing adsorption
systems, extract oxygen from air
by differential adsorption. These
Fig. 1.21 Schematic diagram of a liquid oxygen supply system. devices may be small, designed to
supply oxygen to a single patient
(Fig. 1.22), supply oxygen to an
the critical temperature) and at a the mass of the liquid. More anaesthetic machine (Fig. 1.23) or
pressure of 10.5 bars. recently, a differential they can be large enough to supply
2. The temperature of the vessel is pressure gauge which oxygen for a medical gas pipeline
maintained by the high-vacuum measures the pressure system (Fig. 1.24).
shell. Evaporation of the liquid difference between the
oxygen requires heat (latent heat bottom and top of the liquid
Components
of vaporization). This heat is oxygen can be used instead.
taken from the liquid oxygen, The information obtained is A zeolite molecular sieve is used.
helping to maintain its low sent to the hospital alarm Zeolites are hydrated aluminium
temperature. system. As liquid oxygen silicates of the alkaline earth metals
3. The storage vessel rests on a evaporates, its mass in a powder or granular form.
weighing balance to measure decreases, reducing the Many zeolite columns are used.
 Entonox (BOC Medical) 11

3. The sieve selectively retains

nitrogen and other unwanted
components of air. These are
released into the atmosphere
after heating the column and
applying a vacuum.
4. The changeover between
columns is made by a time
switch, typically cycles of
around 20 seconds, allowing for
a continuous supply of oxygen.
5. The maximum oxygen
concentration achieved is 95%
by volume. Argon is the main
remaining constituent.
6. The life of the zeolite crystal can
be expected to be at least 20 000
hours (which is about 10 years
of use). Routine maintenance
consists of changing filters at
regular intervals.

Problems in practice and

safety features
Although the oxygen concentration
achieved is sufficient for the vast
Fig. 1.22 The portable Eclipse 3 home
oxygen concentaror. (Courtesy of Chart majority of clinical applications, its
BioMedical Ltd.) Fig. 1.23 The universal anaesthetic use with the circle system leads to
machine (UAM) which has a built-in argon accumulation. To avoid this,
oxygen concentrator (see Ch. 2 for higher fresh gas flows are required.
Mechanism of action more details). (Courtesy of UAM Global.)
(Fig. 1.25)
2. Air is exposed to a zeolite Source of supply
1. Ambient air is filtered and molecular sieve column, ● Cylinder manifold: banks of large
pressurized to about 137 kPa by forming a very large surface cylinders, usually size J, are used.
a compressor. area, at a certain pressure. ● Liquid oxygen: a thermally
insulated vessel at a temperature
of −150° to −170°C and at a
pressure of 5–10 atmospheres is
used.
● Oxygen concentrator: a zeolite
molecular sieve is used.

Entonox (BOC
Medical)
This is a compressed gas mixture
containing 50% oxygen and 50%
nitrous oxide by volume. It is
Fig. 1.24 The RA40/D/M hospital oxygen concentrator. It produces 80 L/min of oxygen. commonly used in the casualty and
(Courtesy of Rimer Alco Ltd.) labour ward settings to provide
12 1 Medical gas supply

93% Oxygen To anaesthetic machine

and patient

Tank

Zeolite towers

Nitrogen vent

Fig. 1.26 An Entonox cylinder and

delivery system.

Switch valve ● above the liquid, a gas mixture

of high oxygen concentration.
Compressor This means that when used at a
constant flow rate, a gas with a high
concentration of oxygen is supplied
Room air first. This is followed by a gas of
21% oxygen decreasing oxygen concentration as
Fig. 1.25 Mechanism of action of a concentrator. the liquid evaporates. This may lead

analgesia. A two-stage pressure

demand regulator is attached to the Diaphragm
Entonox cylinder when in use (Figs Corrugated hose Safety 1st stage
1.26 and 1.27). As the patient valve reduction
Spring
inspires through the mask or mouth
piece, gas flow is allowed to occur. 2nd stage pressure
Gas flow ceases at the end of an Non-interchangeable
reduction (atmospheric) cylinder valve and yoke
inspiratory effort. Entonox is
compressed into cylinders to a Filter
pressure of 13 700 kPa. Entonox
cylinders should be stored at 10°C
for 24 hours before use.
If the temperature of the Entonox
cylinder is decreased to below
−5.5°C, liquefaction and separation Sensing diaphragm 1st stage valve
of the two components occur
2nd stage
(Poynting effect). This results in:
(tilting type) valve Gas cylinder
● a liquid mixture containing Fig. 1.27 The Entonox two-stage pressure demand regulator. (From Aitkenhead
mostly nitrous oxide with about AR, Smith G, Rowbotham DJ (2007) Textbook of Anaesthesia, 5th edn. Churchill
20% oxygen dissolved in it Livingstone, with permission.)
 Centralized vacuum or suction system 13

Centralized vacuum
or suction system
(Fig. 1.29)
Suction devices play a crucial
part in the care of patients in the
operating theatre, intensive care unit
and other parts of the hospital.

Components
1. A pump or a power source that
is capable of continuously
generating a negative pressure of
−500 mmHg.
2. A suction controller with a filter.
3. A receiver or a collection vessel.
4. A suction tubing and suction
Fig. 1.28 Compressed medical air plant. (Courtesy of Penlon Ltd, Abingdon, UK
nozzle (e.g. a Yankaeur sucker)
(www.penlon.com).)
or catheter.

to the supply of hypoxic mixtures, should be avoided because of the To determine the efficiency of
with less than 20% oxygen, as the effect of nitrous oxide on the central-piped vacuum systems
cylinder is nearly empty. bone marrow especially in the ● A negative pressure of at least
Rewarming and mixing of both critically ill patient. Adequate −53 kPa (−400 mmHg) should
the cylinder and its contents reverses facilities for scavenging should be maintained at the outlet.
the separation and liquefaction. be provided to protect hospital ● Each central-piped vacuum
staff. outlet should be able to
Problems in practice and withstand a flow of free air of at
safety features least 40 L/min.
● A unit should take no longer
Liquefaction and separation of the
components can be prevented by:
Compressed air than 10 seconds to generate a
vacuum (500 mmHg) with a
1. Cylinders being stored Medical air is supplied in a hospital displacement of air of 25 L/min.
horizontally for about 24 hours for clinical uses or to drive power
at temperatures of or above 5°C tools. The former is supplied at
before use. The horizontal a pressure of 400 kPa and the
Mechanism of action
position increases the area for latter at 700 kPa. The anaesthetic
diffusion. If the contents are machines and most intensive care 1. Negative pressure is generated
well mixed by repeated ventilator blenders accept a 400 kPa by an electric motor and
inversion, cylinders can be used supply. The terminal outlets for the pneumatic-driven pumps using
earlier than 24 hours. two pressures are different to the Venturi principle.
2. Large cylinders are equipped prevent misconnection. 2. The amount of vacuum
with a dip tube with its tip Air may be supplied from cylinder generated can be manually
ending in the liquid phase. manifolds, or more economically adjusted by the suction
This results in the liquid being from a compressor plant with duty controller. This device has a
used first, preventing the and back-up compressors (Fig. 1.28). variable orifice with a float
delivery of an oxygen Oil-free medical air is cleaned by assembly, a back-up filter to
concentration of less than 20%. filters and separators and then dried prevent liquid entering the
Prolonged use of Entonox before use. system and ports to connect to a
14 1 Medical gas supply

Centralized vacuum
or suction system
● Consists of a power source, a
suction controller, a receiver, a
suction tubing and suction
nozzle.
● Efficiency of the system should
be tested before use.
● The amount of negative pressure
should be adjusted according to
its use.
● Trauma to tissues can be caused
by the suction.

FURTHER READING
Health Technical Memorandum 2022,
1997. Medical gas pipeline systems.
The Stationery Office, London
Fig. 1.29 Medical vacuum plant. (Courtesy of Penlon Ltd, Abingdon, UK (www.penlon. Health Technical Memorandum 02-01,
com).) 2006. Medical gas pipeline systems,
part A; design, installation, validation
and verification.
The Stationery Office, London.
Health Technical Memorandum 02-01,
2006. Medical gas pipeline systems,
collection vessel or reservoir 6. Bacterial filters are used to part B; operational management.
through flexible tubing. prevent spread of infectious The Stationery Office, London.
3. The reservoir must have bacteria, with a removal of Highly, D., 2009. Medical gases, their
sufficient capacity to receive the 99.999% of bacteria. Filters are storage and delivery. Anaesthesia
aspirated material. Too large a also used to prevent fluids, and Intensive Care Medicine 10 (11),
capacity will make the system condensate and smoke from 523–527.
cumbersome and will take a contaminating the system. MHRA, 2011. Medical device alert:
long time to generate adequate 7. It is recommended that there anaesthetic machine: auxillary
negative pressure. are at least two vacuum outlets common gas outlet (ACGO)
4. The suction tubing should be per each operating theatre, manufactured by GE Healthcare
flexible and firm to prevent one per anaesthetic room (MDA/2011/118). Online. Available
collapse. Also it should be and one per recovery or at: http://www.mhra.gov.uk/
transparent so that the contents intensive care unit bed. Publications/Safetywarnings/
aspirated can be visualized, and MedicalDeviceAlerts/CON137664
of sufficient internal diameter National Health Service, 2009. Oxygen
Problems in practice and
and length for optimal suction. safety in hospitals. Online. Available
safety features
5. The negative pressure (or degree at: http://www.nrls.npsa.nhs.uk/resou
of suctioning) can be adjusted to To prevent trauma to the tissues rces/?entryid45=62811&p=7
suit its use; e.g. a lesser degree during suction, the nozzles should Poolacherla, R., Nickells, J., 2006.
of suctioning is required to clear taper, be smooth and have multiple Suction devices. Anaesthesia and
oral secretions in a child than in holes, so that if one is blocked the Intensive Care Medicine 7 (10),
an adult. others will continue suction. 354–355.
 MCQs 15

MCQs
In the following lists, which of the statements (a) to (e) are true?

1. Concerning cylinders: 4. Oxygen concentrators: 7. Concerning piped gas supply in

a) Oxygen is stored in cylinders a) Oxygen concentrators the operating theatre:
as a gas. concentrate O2 that has been a) Compressed air is supplied
b) The pressure in a half-filled delivered from an oxygen only under one pressure.
oxygen cylinder is 13 700 kPa. cylinder manifold. b) The NIST system is the British
c) The pressure in a half-full b) Argon accumulation can Standard.
nitrous oxide cylinder is occur when oxygen c) Only oxygen and air are
4400 kPa. concentrators are used with supplied.
d) Nitrous oxide is stored in the the circle system. d) E-size cylinders are normally
cylinder in the gas phase. c) They are made of columns of used in cylinder manifolds.
e) Pressure in a full Entonox a zeolite molecular sieve. e) Liquid oxygen is stored at
cylinder is 13 700 kPa. d) They can achieve O2 temperatures above −100°C.
concentrations of up to
100%.
2. Entonox: 8. True or false:
e) They can only be used in
a) Entonox is 50 : 50 mixture by a) There is no need for cylinders
home oxygen therapy.
weight of O2 and N2O. to undergo regular checks.
b) Entonox has a critical b) The only agent identification
temperature of 5.5°C. 5. Oxygen: on the cylinder is its colour.
c) Entonox cylinders should be a) Oxygen is stored in cylinders c) When attached to the
stored upright. at approximately 140 bars. anaesthetic machine, the
d) At room temperature, b) It has a critical temperature of cylinder valve should be
Entonox cylinders contain 36.5°C. opened slowly.
only gas. c) It is a liquid in its cylinder. d) When warmed, liquid oxygen
e) Entonox cylinders have blue d) It may form an inflammable can give 842 times its volume
bodies and white and blue mixture with oil. as gas.
quarters on the shoulders. e) It obeys Boyle’s law. e) Cylinders are made of
thick-walled steel to withstand
the high internal pressure.
3. Oxygen: 6. Concerning cylinders:
a) For medical use, oxygen is a) The filling ratio = weight of
usually formed from fractional liquid in the cylinder divided
SINGLE BEST ANSWER (SBA)
distillation of air. by the weight of water
b) Long-term use can cause bone required to fill the cylinder.
9. Concerning piped medical gas
marrow depression. b) The tare weight is the weight
and vacuum (PMGV):
c) In hyperbaric concentrations, of the cylinder plus its
a) Outlets are only colour-coded.
oxygen may cause contents.
b) Outlets are shape- and
convulsions. c) Nitrous oxide cylinders have a
colour-coded.
d) At constant volume, the blue body and blue and white
c) All the supplies can be
absolute pressure of oxygen is top.
interrupted using a single
directly proportional to its d) A full oxygen cylinder has a
AVSU.
absolute temperature. pressure of approximately
d) Copper sulphate pipes are
e) The critical temperature of 137 bars.
used to carry oxygen
oxygen is −118°C. e) At 40°C, a nitrous oxide
throughout the hospital.
cylinder contains both liquid
e) Back-up cylinders for the
and vapour.
oxygen supply are
undesirable.
16 1 Medical gas supply

Answers

1. Concerning cylinders: oxide and about 20% oxygen. 4. Oxygen concentrators:

a) True. Oxygen is stored in the Above the liquid is a gaseous a) False. Oxygen concentrators
cylinder as a gas. mixture with a high extract oxygen from air using
b) False. Oxygen is stored as a concentration of oxygen. a zeolite molecular sieve.
gas in the cylinder where gas c) False. This increases the risk Many columns of zeolite are
laws apply. The pressure of liquefaction and separation used. Zeolites are hydrated
gauge accurately reflects the of the components. To prevent aluminium silicates of the
contents of the cylinder. A full this, Entonox cylinders should alkaline earth metals.
oxygen cylinder has a pressure be stored horizontally for b) True. The maximum oxygen
of 13 700 kPa. Pressure in a about 24 hours at concentration achieved by
half-full oxygen cylinder is temperatures at or above 5°C. oxygen concentrators is 95%.
therefore 6850 kPa. This position increases the The rest is mainly argon.
c) True. Nitrous oxide is stored area for diffusion. With Using low flows with the
in the cylinder in the liquid repeated inversion, Entonox circle breathing system can
form. The pressure of a full cylinders can be used earlier lead to the accumulation of
nitrous oxide cylinder is about than 24 hours. argon. Higher fresh gas flows
4400 kPa. As the cylinder is d) True. Liquefaction and are required to avoid this.
used, the vapour above the separation of nitrous oxide c) True. The zeolite molecular
liquid is used first. This and oxygen occurs at or sieve selectively retains
vapour is replaced by new below −5.5°C. nitrogen and other unwanted
vapour from the liquid. e) True. gases in air. These are released
Therefore the pressure is into the atmosphere. The
maintained. So the cylinder is 3. Oxygen: changeover between columns
nearly empty before the a) True. Except for oxygen is made by a time switch.
pressure starts to decrease. concentrators which use d) False. Oxygen concentrators
For this reason, the pressure zeolites. can deliver a maximum
gauge does not accurately b) False. Long-term use of oxygen concentration of 95%.
reflect the contents of the oxygen has no effect on the e) False. Oxygen concentrators
cylinder. bone marrow. Long-term use can be small, delivering
d) False. Nitrous oxide is stored of N2O can cause bone oxygen to a single patient, or
in the cylinder as a liquid. marrow depression especially they can be large enough to
The vapour above the liquid with high concentrations in supply oxygen to hospitals.
is delivered to the patient. critically ill patients.
e) True. Entonox is a c) True. 5. Oxygen:
compressed gas mixture d) True. This is Gay–Lussac’s a) True. Molybdenum steel or
containing 50% oxygen and law where pressure = constant aluminium alloy cylinders are
50% nitrous oxide by volume. × temperature. Oxygen also used to store oxygen at
obeys the other gas laws pressures of approximately
2. Entonox: (Dalton’s law of partial 14 000 kVa (140 bars).
a) False. Entonox is a 50 : 50 pressures, Boyle’s and b) False. The critical temperature
mixture of O2 and N2O by Charles’s laws). of O2 is −118°C. Above that
volume and not by weight. e) True. At or below −118°C, temperature, oxygen cannot
b) False. The critical temperature oxygen changes to the liquid be liquefied however much
of Entonox is −5.5°C. At or phase. This is used in the pressure is applied.
below this temperature, design of the vacuum c) False. Oxygen is a gas in the
liquefaction and separation of insulated evaporator where cylinder as its critical
the two components occurs. oxygen is stored in the liquid temperature is −118°C.
This results in a liquid phase at temperatures of −150 d) True. Oil is flammable while
mixture of mainly nitrous to −170°C. oxygen aids combustion.
 Answers 17

Oxygen cylinders should be

7. Concerning piped gas supply in 8. True or false:
stored away from oil.
the operating theatre: a) False. Cylinders should be
e) True. At a constant
a) False. Air is supplied at two checked regularly by the
temperature, the volume of a
different pressures; at 400 kVa manufacturers. Internal
given mass of oxygen varies
when it is delivered to the endoscopic examination,
inversely with the absolute
patient and at 700 kPa when pressure testing, flattening,
pressure (volume = constant ×
used to operate power tools in bending and impact testing
1/pressure). Oxygen obeys
the operating theatre. and tensile testing are done on
other gas laws.
b) True. This stands for non- a regular basis.
interchangeable screw thread. b) False. To identify the agent,
6. Concerning cylinders:
This is one of the safety the name, chemical symbol,
a) True. The filling ratio is used
features present in the piped pharmaceutical form and
when filling cylinders with
gas supply system. Flexible specification of the agent, in
liquid, e.g. nitrous oxide. As
colour-coded hoses connect addition to the colour of the
the liquid is less compressible
the outlets to the anaesthetic cylinder are used.
than the gas, the cylinder
machine. The connections to c) True. When attached to an
should be only partially filled.
the anaesthetic machine anaesthetic machine, the
Depending on the ambient
should be permanently fixed cylinder valve should be
temperature, the filling ratio
using a nut and liner union opened slowly to prevent the
can be from 0.67 to 0.75.
where the thread is gas- rapid rise in pressure within
b) False. The tare weight is the
specific and the machine’s pipelines.
weight of the empty cylinder.
non-interchangeable. d) True. It is more economical to
This is used to estimate the
c) False. Oxygen, nitrous oxide, store oxygen as liquid before
amount of the contents of the
air and vacuum can be supplying it. At a temperature
cylinder. It is one of the
supplied by the piped gas of 15°C and atmospheric
marks engraved on the
system. pressure, liquid oxygen can
cylinders.
d) False. Larger cylinders, e.g. J give 842 times its volume as
c) False. Nitrous oxide cylinders
size, are normally used in a gas.
have a blue body and top.
cylinder manifold. E-size e) False. For ease of transport,
Entonox cylinders have a blue
cylinders are usually mounted cylinders are made of thin-
body and blue and white top.
on the anaesthetic machine. walled seamless molybdenum
d) True.
e) False. Liquid oxygen has to steel. They are designed to
e) False. At 40°C, nitrous oxide
be stored at temperatures withstand considerable
exists as a gas only. This is
below its critical temperature, internal pressures and tested
above its critical temperature,
−118°C. So oxygen stored at up to pressures of about
36.5°C, so it cannot be
temperatures above −100°C 22 000 kPa.
liquefied above that.
(above its critical temperature)
exists as a gas. 9. b)
This page intentionally left blank
 19

Chapter 2

The
anaesthetic
machine
Exploring the Variety of Random
Documents with Different Content
The text on this page is estimated to be only 26.51%
accurate

ELEVATIONS 117 and taking readings on rods held at these

two points. The difference in elevation is equal to the difference
between these two rod readings, AC and DB. It frequently happens
that more than one set-up of the instrument is necessary and an
intermediate point has to be used in order to reach B. Work X 8GO
X856 :837 X818 X841 X829 X831 X821* 800 X828 X 825 X837 791
FIG. 64. — Contour Interpolations Exercise. of this kind is done with
several types of instruments, the simplest of which is the hand level.
Such work, however, while accurate, is not rapid and is therefore not
suited to sketch mapping. In sketch mapping the method followed is
to determine
The text on this page is estimated to be only 28.87%
accurate

118 CONTOUR MAPPING the vertical angle of one point

above another, and, knowing this angle and the horizontal distance,
the difference in elevation can be computed or obtained graphically.
To measure the vertical angle, either a clinometer or a slope board
FIG. 65. — Spirit Leveling. is used. Several forms of clinometers
have been devised by means of which the vertical angle can be quite
accurately and rapidly measured, but the slope board is the simplest
device available and though clumsy is quite as accurate as most
clinometers. The slope board is shown as part of the FIG. 66.—
Method of Using Slope Board. sketch case equipment in Fig. 55. It is
also illustrated in Fig. 66, which shows the method of holding the
board in the left hand while the plumb line is steadied by the right
hand, the vertical angle being read on the scale at the lower edge of
the board.
The text on this page is estimated to be only 28.98%
accurate

MEASUREMENT OF ELEVATIONS 119 When using the slope

board it is held at the level of the eye, which is about five feet above
the ground. In order to make the line of sight parallel to the inclined
distance and obtain the true vertical angle it is necessary to sight an
equal distance above the point B. In Fig. 67 the observer at A sights
at his assistant at B and the line of sight FD is parallel to the inclined
distance AB, hence the angle DFE equals the vertical angle BAG. The
distance, DE, which is obtained by using the former angle and the
horizontal distance AC, equals the true difference in elevation, BC. It
is frequently inconvenient and it is unnecessary to send an assistant
to stand at the point B which is sighted to. Instead of sighting at the
correct distance above the ground level at B the observer can sight
at the ground and correct the distance of elevation FIG. 67. —
Measurement of True Vertical Angle. so obtained by about five feet,
thus allowing for the height of his eye above the ground. Note that
this correction must be added to differences in elevation which are
upward and subtracted from distances which are downward. In Fig.
68 the vertical angle measured by the slope board is not the true
angle and the difference in elevation obtained by using it is BD,
while the true difference in elevation is BC or equals BD plus the
height of the observer's eye above the ground DC. In Fig. 69 where
the sight is downward, the difference in elevation obtained by using
the angle measured with the slope board is DC which must be
corrected by subtracting the height DA, as the true difference in
elevation equals AC. In order to obtain the difference in elevation
the horizontal distance is always necessary, as well as the vertical
angle. This does not always require pacing the distance to
The text on this page is estimated to be only 28.37%
accurate

120 CONTOUR MAPPING the object sighted. A point may be

located, for example, by intersections, in which case the horizontal
distance can be scaled from the map by using the reading scale on
the alidade. Indeed the diagram, Fig. 70, described below, requires
that FIG. 68. — Correction of an Upward Sight. the horizontal
distance shall be in yards, and it is therefore necessary to scale from
the map the horizontal distances used in determining the difference
in elevation. Knowing the vertical angle and the horizontal distance
the difference in FIG. 69. — Correction of a Downward Sight.
elevation is found by solving the right-angle triangle ABC of Fig. 53
for the side EC. That is, we may lay off the vertical angle BAG to
scale and also the horizontal distance, and then scale off the height
EC. Or we may solve this triangle by proper mathematical formulae.
A large amount of time and labor can be saved by using a slope
diagram such as that
The text on this page is estimated to be only 18.50%
accurate

MEASUREMENT OF ELEVATIONS 8 g S 8 S? S S f. S
The text on this page is estimated to be only 29.35%
accurate

122 CONTOUR MAPPING illustrated in Fig. 70, which

consists simply, of a drawing to scale showing a large number of
vertical angles and horizontal distances which enable us to secure
graphically the difference in elevation without making a separate
drawing for each problem. If a horizontal distance, for example, is
500 yds., and the vertical angle is 3°, the difference in elevation may
be read on the right-hand edge of the sheet as about 80 ft. If the
distance had been 300 yds. the difference in elevation read in the
same way would have been about 48 ft. Distances greater than 500
yds. can be handled by the same diagram by dividing the distance in
two or more parts and adding together the vertical distances
obtained for each part. EXERCISE Determine the elevation of the
different set-up points in the closed traverse used as the exercise in
connection with Art. 24. Assume the elevation of the starting point
as 100 or any other figure necessary to make all the elevations plus,
that is, above datum. Determine the elevation of the points by using
the slope board and the distance scaled from the map. Continue this
process completely around the traverse and distribute the final error
in elevation in proportion to the length of the sides. ART. 29.
CONTOUR MAPPING The successive steps followed in securing
contours have been dealt with in the last two articles. The student,
however, will find considerable difficulty in putting the process into
practice in the field. He must first of all learn to do the reverse of
visualizing relief from the contours. In other words he must learn to
picture in his mind the proper contour forms for the different hills
and valleys which he actually sees in the field and to sketch in these
contours on his map. This will require considerable practice, and
some men will be far more proficient in doing this than others. One
of the most important points in contouring work is to analyze the
relief visible from any set-up and to decide upon a suitable scheme
of controlling or critical points which will give adequate data for the
actual work of interpolating and sketching in the contours
themselves. The contouring, of course, proceeds continuously with
each
The text on this page is estimated to be only 29.35%
accurate

CONTOUR MAPPING 123 set-up of the instrument in just

the same manner as the location of details. It is probably best to
locate the details first and then obtain the location and the elevation
of the controlling points on the map, finally sketching in the contours
just before leaving the set-up. It is seldom indeed that anything but
the roughest kind of contours can be drawn from any one set-up
without actually moving over the ground and noting its
conformation. For this reason the instrument man should call to the
table his assistants who have been over the area and who can help
him in the work of properly interpreting the relief by contours. It is
desirable to use a colored pencil for the contours, as they otherwise
may not show up properly or may be confused with other lines on
the map. Where compactness and lightness of equipment is
essential the additional slope board may be done away with and the
sketch board itself used also as a slope board. The alidade may be
used instead of a plumb bob and the slope scale and reduction
diagram may be placed on opposite sides of the board. In locating
the contours from any one set-up it is always desirable, as noted
above, to have in mind a certain definite scheme or method of
attack. For this reason it is well to proceed as follows: 1. Having
located the point of set-up and while securing the topographical
details near this point by radiation or other methods, the instrument
man should study the relief, noting the drainage and hill forms in
order that he may have clearly in mind the points which he will
adopt as controlling points for the contouring. Note in this
connection that it will frequently happen that points located on the
map to show topographical details may also be suitably located for
contour points. 2. An assistant should use the slope board and by its
means determine the elevation of the point of set-up, secure the
vertical angles to various points already on the map which are to be
used for contouring points, and compute their elevations. These
elevations should be noted on the map by the mapper. 3. The
mapper should then proceed to locate additional
The text on this page is estimated to be only 29.05%
accurate

124 CONTOUR MAPPING contour points while his assistant

at the same time determines their elevations by means of the slope
board. 4. The contours are now interpolated exactly as described hi
Art. 27 and are drawn-in in the field, where the ground is in front of
the mapper. Note particularly that contours which pass out of view
or are in back of hills cannot be drawn without proper observations,
and no contours should be guessed at which are out of sight unless
special note is made of the fact that such portions are simply
probable contours and not accurately determined. This may be done
by showing such contours with a dotted instead of a full line.
EXERCISES 1. (a) Place a piece of tracing paper over the upper
right-hand corner (say six inch square) of the Hunterstown sheet,
which will be found in the back cover, and mark on this paper the
drainage lines and what you believe to be the necessary controlling
points to make a contour map of this area; (6) estimate the
elevations of these points from the contours; (c) remove the map
and interpolate contours from these selected points as described in
Art. 27; (d) compare the contours so drawn with the original map. In
this way obtain some practice in the selection of controlling points
for different forms of relief. 2. Contour carefully a small area, using
the sketch and slope boards and showing contours .alone. 3.
Complete the map used as an exercise in previous articles by filling
in the contours of the entire area.
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PART III LANDSCAPE SKETCHING INTRODUCTION

Landscape, or Panoramic Sketching, is used to a large extent in
military work in making conventionalized pictures, particularly from
artillery positions. These sketches show the enemy positions with
approximate ranges and with descriptions of important targets. They
are sometimes made by reconnaissance parties or again are made
as a record of an enemy position for the information of the next
detachment, or. relief, occupying the position from which the sketch
was made. A sketch of this kind is simply a conventionalized, outline,
perspective drawing showing the view from any position, and with
additional data in reference to the direction and range of important
targets, such as points of special enemy activity, etc. The student
should understand that a landscape sketch is not an artistic effort.
The work must often be done very rapidly and many sketches show
only rough crest lines with indications of intervening ridges and hills.
Only outlines are shown — the minute and smaller details being left
out — and it is preferable to think of a landscape sketch simply as a
map in a vertical, instead of a horizontal plane. It is drawn to scale
just like other maps. In order to make a sketch four steps are
necessary. 1, A system of delineations, or special conventional signs
suitable for this work, must be agreed upon; 2, the student must
have some knowledge of perspective, as this is essential in putting
these signs together so as to form even a rough landscape sketch;
3, inasmuch as the sketch is to be drawn 125
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126 LANDSCAPE SKETCHING RELIEF Mou/rfain Skyline -

Sharp , angular Hill Outlines - Smooth , rounding rounding
downward. upward. from Elm Pine JT X Cedar Maple Poplar Oak
Nillo* Hood5 - back ofcresr BUILDINGS ». -In -foreground Orchard
house £arn Church Factory Windmill L form 6rqvp Tdnk Haysfack
FENCESBoard Fence darted Hire Worm Stone FIG. 71. —
Delineations.
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DELINEATIONS 127 to scale and points must be shown in

their proper relative position, particularly as regards direction, the
sketcher must be familiar with the scale used; and 4, he must know
how to locate on his sketch the main features of the landscape so as
to secure guide points which will control the freehand work of
sketching in the other features and give accuracy to the sketch.
These various steps will be discussed in order. ART. 30.
DELINEATIONS AND PERSPECTIVE As stated above delineations are
simply the conventional signs of landscape sketching. They are not
nearly as mechanical, neither have they been as thoroughly
standardized or conventionalized as those used for "horizontal"
maps, hence there is considerable opportunity for the sketcher to
add to the neatness and appearance of his sketch if he possesses
special ability in freehand work. On the other hand men with this
ability frequently go to the extreme and try to show too much, while
the novice goes ahead in a much cruder way and finally produces,
not a "beautiful" sketch, but a simple outline drawing which is just
as, if not more, useful. The main thing to work for in practicing
delineations is a simple outline which will be suggestive of the object
represented. Figs. 71 and 72 show some simple forms which should
be copied, not with the idea that they will cover all possible objects,
but that they will suggest similar simple outline treatment for other
objects. In order that the sketch may give a correct impression of
the landscape represented it is necessary for the sketcher to give
such effect of distance and perspective as his skill permits. The
former effect is secured by drawing the delinations of the more
distant objects smaller in size, just as these objects actually appear,
with a fine light line and increasing the weight of the line used for
objects nearer the observer. The rough outlines of one or two
objects in the foreground frequently assists in securing the effect,
but such objects should be sparingly shown, as they are of no
importance except in this connection and in assisting to identify the
point from which the sketch was made.
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128 LANDSCAPE SKETCHING CULTIVATION Plowed Land

PERSPECTIVE FIG. 72. — Delineations and Perspective.
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PERSPECTIVE 129 In connection with perspective it is

particularly necessary that the student should understand the simple
principles illustrated in Figs. 72 and 73. All parallel lines, such as the
sides of roads, for example, or imaginary lines, such as those
indicated in the sketch in the lower part of Fig. 72, appear to
gradually converge as they become more distant from the observer
and finally seem to meet at a point known as the vanishing point.
Also note in this simple perspective how the PERSPECTIVE PLAN O d
Or FIG. 73. — Perspective of a Circular Path. spacing of the poles of
the telegraph line becomes smaller and smaller the further they are
away. Now note the delineations shown above for fences, roads,
etc., and how this same perspective effect is secured. Another
feature in perspective is shown in Fig. 73. Imagine a circular
driveway or track. The perspective appears wider in the foreground
ab than at the back cd as shown in the sketch, due to the fact that
the angle subtended at the eye by the two edges of the roadway is
greater for the nearer portion. Also note that the sides at e and /
appear their
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130 LANDSCAPE SKETCHING

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THE SKETCHING SCREEN 131 full width. Applying these

same principles to the case of a winding stream we understand how
the stream shown in Fig. 72 is drawn. Fig. 74 shows a landscape
sketch and illustrates how various delineations are combined to
produce a clear drawing when due allowance is made for perspective
effect. Note the varying size of the delineations and also the
variation in the thickness of the line used which, together with the
rough indication of foreground objects, gives the effect of distance.
EXERCISES 1. Copy Fig. 71. 2. Draw the required number of vertical
lines one inch apart and horizontal lines at half this distance and
enlarge Fig. 74 by the same process followed in the method of
squares, Art. 21. ART. 31. THE SKETCHING SCREEN The sketching
screen is a device which is never used by the experienced sketcher
but is of value in assisting the FIG. 75 —The Sketching Screen.
beginner. It consists of a rectangular frame, as shown in Fig. 75,
fastened to one end of a horizontal bar, the entire apparatus being
mounted on a tripod. A series of vertical and horizontal cords divide
the opening in the frame into rectangles. When this apparatus is set
up, as illustrated in the figure, and the observer looks through the
screen the vertical and horizontal cords will divide the portion of the
landscape, viewed through the frame, into a series of rectangles.
The extent of country covered by each rectangle will, of course,
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