SECTION 2

ILL TIO>N
HOSPITAL LIGHTI:'\G
By D. C. PRITCHARD, B.Sc.
T
HE importance of a good standard of lighting throughout the hospital
demands a full understanding by the hospital engine::.- of the \'arious prob-
lems invohed. Not only does safety depend on lighting, but also the working
conditions ::nd general atmosphere of the wards, thea:res and staff quarters.
A well-lit room is a physical encouragement to promote higher standa rds of
cleanliness and efficiency and psychological ton ic to both nar.ients and staff.
Good lighting is not just the provision of an adequ::te amount of light,
but is dependent on the good design of the fitting provi di .g it. A ward can be
lit to recommended standa rds by using shall ow conic2l metal shades and ex-
posed lamps. The result is a continual source of gl::ne and di scomfort to
everyone. A pleasing design may overcome the probiem of gl2re, but if it is
difficult to clean and maintain, there will be a tendency lO return to the open
FIG. I.-TYPICAL WARD LIGHTI:--IG L AYOUT
The light fittings give a reduction of glare and provide a fair amount of indirect light.
(Fall:, S1ad<imann & Co., L1d.)
17
18 ELECTRICAL EQUIPMENT
shade as at least being "trouble free''. Only when the required standard of
. illumination has been provided by a_clean, well-constructed, both optically and
mechanical:y, fitting installed in the correct position can the lighting be satis-
factory.
Standards of Illumination /
The figures given in Table I are the minimum illumination values as recom-
mended by the Illuminating Engineeri ng Society. An installation should be
planned ro pro,icie these values not initially, but under average conditions.
Allowances would have to be made for deterioration in room decorations, dust
collection, and a,er2ge through life light output figures for lamps.
I
TABLE I
VALCES OF
As p11blislted by rite Illuminating Engineering
Society 1955
Wards and private rooms
Wait ing and receiYing rooms
table
Oper::. cing Theatre

Bedh-22d lighting
Ware night li ghting
;--: igh< nurses room
:\ight nurses ward table
L11mens p er sq. ft.
3
7
300
30
10
15
Jess than Ql
5.......... ._) "
(' s
Calculation of Illumination Values
Detailed formul2 and tables are given in illuminating engineering books, and
it is a dangerous principle to rely on 'rule of thumb methods. Il lumination
values worked out on a 'wattage per square foot" basis are often very far from
correct.
The following summary is given to allow calculations to be made for a
straightforward insrallation. Some assumptions must be made regarding
maintenance and reflection factors but, provided the design of fitting is normal,
then the resulrs will be a fair indication of practical conditions.
To calculare rhe average illumination in a room it is necessary to know.
(a) The light output of the lamps (see Table Ill).
(b) The proportion of light which reaches the working level. This proportion
is known as the Coefficient of Utilisation and can be calculated from Table II.
The figure depends on the type of fitting. room dimensions, and \Vall and ceiling
reflection factors: As a guide to this last point, the following are a list of cl ean
colours and their normal reflection factors:
GE!\ERAL HOSPITAL LIGHTING 19
TABLE II
COEFFJCJE!'\TS OF UTJLISATJON FOR TYPJCAL LJGHTJ!'\G FlTTll\GS

I
I
ReflecJion FacJOr
----,1 i --
Ceiling li j,
Fining
_____ f--;:--lw:;--- .--'0 - i- .. -
I . o / o
1
- (, \ u
_R_o_o_n_1_R_ a_1i-o --- ----'----
-------------- ------i:----:---
Open Ref1ectors 6
]0
15
20
30
33 -2s it
45 38 !r
so 45 1
55 49 I:
60 55 1:
32
43 33
49
54 49
. 59 55
------------------------- ----- ------ ----
Opal glass enclosed fittings.
-------------------------
Opal glass fittings with open bot-
toms
---------------------
White, light cream, yellow
I
6 ! 23 !6
JO II 33 25
]5 40 32 I
, 2-0 ! 44 36
30 I 51 42 ,
_ _ :_ ---1--- ___ '_
11 I
6
10
15
20
3 0
jl I
: 45 I I
1
[ 50 1 41
ij -s7 1 47
2!
-:29
35
39
-+4
24
34
40
44
50
:1 i
-----"----- ----------- . .
15
23
2S
32
37
17
27
32
36
-+2
Light stone, deep yellow, pale green or pale blue
Light brown, grey, green, blue. pink
70 per cent or more
50 per cent or more
30 per cent or more
10 per cent or more
Brown, red, dark green, blue
In order to calculate the Coefficient of Utilisation, it is also necessary to
determine the room ratio number. For the type of fittings discussed here, the
formula for room ratio is given by:
Width in ft. x Length in ft.
Room ratio = -------------------------------------------------
(Width in ft. -;.: Length in ft.) >( Height of fining above
working level
20 MEDICAL ELE-CTRICAL
The E is given b\ the formula :
LxNxCxM.
E Lumens per sq. ft
A
where L = Light output of lamp (see Table HI).
N =Number ofJamps.
C = Coefficient of Utilisation (see Table JJ) .
.\f = Maimenance facwr (08 is an average value) .
.-\ = Area of room.
Example. - A laboratory 30ft. long by 25ft. wide and 10ft. high, is to be
lit by '200-,:att metal reflectors. The ceilings are white and the walls bro'\n.
The fittings will be 9ft. above rhe floor. Using 14 fittings, what will be tile
average iliumination level?
30 X 25
First find the room ratio, which is ------------- = 20
(30 + 25) X 65
No" find the coefficient of utilisation from Table II. which is 0-19.
The lamp light output from Table Ill is 2,725 lumens
2725 X 1-1 X 049 :-: 08
:. the average illumination = ----------------
30 X 25
= 20 lumens per sq. ft.
General Fittings Construction
Before considering the lighting of specific areas. there are construct ional
features which should be studied when choosing the fitting. lt can be assumed
that lighting: equipment used in a hospital will not only be handled by engineers
but also by cleaners. nursing: staff, and patients.
The following points should be noted:
1. lf glassware is used, is it easily replaceable?
2. If metal is used, is it treated against corrosion? If chipped will the
metal rust when damp?
3. Is access to the lamp simple, or are special tools necessary?
4. Are all fixing screws of the captive type?
5. Are there any sharp edges, or any parts which are difficult to clean?
6. If the fitting is adjustable, is it robust enough to withstand a certain
amount of mishandling?
7. Are all the components (fampholders, backplates, suspension roes, etc.)
locked so they cannot unscrew?
8. Is earthing provided?
J . ........ - j
Watts
15
20
30
40 (2'):
40 (4 ')
80
125
GENERAL HOSPITAL LIGHTING
T ABLE III
LAMP LIGHT OUTPUT VA LUES
. 200/250 Volt General Senice Filament Lamps
Al'erage Lumen Value Through Life I
Watts
25
40
60
75
100
!50
200
300
500
Single Coil
206
330
584
785
11 60
1970
2725
4430
7930
Coiled Coil
389
665
883
1270
I
I
I
I
' !
HoT CATHODE F LUORESCENT LA\tPS
New J1
1
arm
White
540
900
1530
1360
2280
4240
7000
A rerage Lumen Value Through Lite
Daylight l':arural DC' Iuxe
ll 'arm
While
555 420 330
80J 640 460
1470 1170 960
1320 !080 760
2200 1680 1440
4080 3200 2640
6750 5375.
21
Colour
,\Ja!ching
-----
375
620
1080
1000
1600
3040
This does not cover all the poi nts, but will act as a guide when inspecting a
new fitting.
WARD LIGHTING
The lighting should provide a cheerf ul atmosphere for both patients and staff.
It must also be flexible to allow the many variations in illumination value that
are required. In planning the lighting there are three distinct tasks:
ELECTRICAL EQUIPMENT
fiG. 2 . -SEMI- RECESSED OR fll"SH
\!OUSTED \\' All BR-\CKET
1 Falk, Stadrimunn &. Cu .. L1d.)
I. G:-ncral lighting .
.., Bedhcad lighting.
3. ?'ight lighting.
FIG. 3.-FIXED PROJECTION
BRACKET
(The General Elcc:tric Co .. Ltd. )
J n sorr1e cases, the saine fitting can ser':e more til an one purpose, but each
task has its own problems.
General Lighting
Up to quite recently the opal sphere or cell shade have been the general choice
of fitting. Although still installed, the !i :Ti itation of this lighting is now fully
realised. Present-day trends are towards the .reduction of glare and the use of
fittings providing a fair component of indirect light. Designs are available
which can meet these require..-nents, whii e at the same time not proving bad
dust-traps.
\VhateYer the form of lighting, the first consideration is the patient. To a
person forced to look in one direction, a glaring light source can cause consider-
able discomfort. It is recommended that the surface brightness (or luminosity)
of a fitting should not exceed I candle.'sq. in. (A bare fluorescent tube has a
brightness of 4 to 6 candles per sq. in. and a pearl tungsten lamp of 130 candles
per sq. in.) .
In positioni.ng the fi ttings it should be remembered that where individual
bed lighting is pro,ided, that the general lighting should illuminate all walking
areas and not be placed over the beds.
GENERAL HOSPITAL LfGHTING
FIG. 4.-ADJUSTABLE PROJECTIO'..:
BRACKET
(Sunplus Products. Ltd.)
Bedhcad Brackets
FIG. 5 .-BRACKET FIXCD TO
BED
One of the most controversial of all lighting fittings is the hospital bcdhcad
unit. It is a fair statement to say that no two engineers agree on the design of
the perfect unit.
There are five main pJllerns a\;tilabl e each with its own ad\antages and
disadvantages. The selection of a pattern is to a large extent governed by the
type of ward. .
Orthopze'dic patients are often supported some distance away from the wall
and a close-to-wall bracket would be useless.
FIG. 6 .. --'-REMOVABLE LIGHT BRACKET
(Folk. Sradlman/1 d: Ca .. Lrd.)
24 :\!EDICAL ELECTRICAL EQUIPMENT
Adjustable units used where a patient cannot r aise his arms above his head
lose their main advantage.
Projecting brackets in a mental hospital present t heir own particular problem.
Consequently the engineers' choice is governed not only by the design of
unit, but also by the use to which it will be put.
The following types of bedhead brackets cover the normal r ange manu-
iactured today.
1. Sn!I- RECESSED OR WALL BRACKETS
Adramages
Usually robust and not easi ly damaged.
Can incorporate other services (radio
plug. socket outlet. bell push).
Easy to clean.
""ieat appearance.
Disad1:antages
Oft en too far behi nd the patient for
good lighting.
Relamping sometimes difficult.
Inflexible.
2. FIXED PROJECTI O:--; BRACKET
- - - -- -- - . .
Disadrantages
Can be robust and not easily damaged. If not robust can be pulled from walL
.
B'"ttcr position for l ighting. Inflexible .
.3 . ADJlJSTAil LE PROJECTJO'\ BRACKET
Admmdges
Good position for lighting.
Ca n also be used to limited extent for
medical examination.
Disadran!agcs
Any movable components li abl e to
mechanical failure, unless of first class
manufacture.
Can cause glare to ot her patients if
badly adjusted.
Can look untidy in general ward.
4. BR.-\CKET FIXED TO BED
Adm!llages
Good position for li ghting.
Very useful if bed posi tions are varied
or extra bed pl aced ward.
Can be used for medical inspection.
Disadvantages
Generally as for 3. above.
l\1 ust be well earthed.
Traiiing flex to socket outlet can be
damaged when bed is moved.
GENERAL HOSPITAL LIGHTING
5. RDIOVABLE ilRACKET
25
Adra111ages
Generally as for fi xed bracket 2. above.
Reflector is removable for use as a
close inspecti on light by nurse or
doctor.
Can be inverted to provide indirect
lighting in private ward.
Disad1antages
Requires trail ing cable which wi ll need
careful electrical checking.
Can be knocked off bracket on to bed
or floor.
With all the above units 40- or 60-watt lamps are normally used.
)iight Lighting
A completl y separate form of low-level lighting at night ;; required to enable
the nursing staff to walk about the ward. lt need not be sufficient to inspect
the patient by, as a separate inspection torch is normally used for this purpose.
The following a rrangements are in use and the choice depends partly on the
existing lighting and on the layout of the ward.
(a) Pi/01 Light JncorporaJed in Cemre If ard Ligl11s.
This is one of the simplest forms of night lighting (see Fig. 7). utilising the
existing fitting. The chief disadvantage is the .. moon .. effect of Jn op:1l gbss
of low brightness suspended jn the ward. The fi tt ings can cause discomfort
by glare to a patient unable to ger to sleep. Fifteen-\\'Jtt are
normally used and in some cases are amber coloured.
(b) Pilo1 Auachn1C'ntfiueci in top o,(Giass Carrier o(Cenm' Ward Lighl.
To overcome t[le brightness of the glass shade and provide low-level indirect
lighting, the night lamps can be incorporated in a separate compartment
(Fig. 8).
c
J

..... ' -
.\
FIG. 7 (abore).- PILOT LIGHT
ATT.:,.CHME;-.1 ]1\CORPORATED !:->
CE:'-.IRE WARD LIGHT
FIG. 8 (right).-PILOT LIGHT
A TTACHMEI'<I frTTED ll\ TOP OF
GLASS CARRIER OF CESTRE WARD
LIGHT
26
. .
ME D ICAL ELECTRICAL EQUIPMEI'\ T
i ,
t

J
- .;,.! ,.. _ '""' - '"' -"" - ...,,_,. wz.,..,.,_..-
fiG. 9. (abon) .- LOl; VRE LIGHTS
FOR BcDHEAD A:-;D CORRIDOR
LtGHTI'-'G
cfu/l .. Swdrlmom: d Co .. Ltd.)
FI G. IO lri_::hr ). - DI\1\IEK Co,'TROL
FOR BED LiGHTS
1 C::r:t.S .\Jwmiac:unng Co., Ltd . }
(c) Series S11'i!chir:g of' Jf'ord Ligh!S.
In a ward of lights can be switched in series to run at 50 ,-olts
or Jess. Tilis elimir.:J.tes the use of specia l lamps. If. however, one lamp fails,
the whok group ,,-ill be extingu ished.
(d ) ll'ul' Ligl11s._
A popubr form is the lighti:1g of the. fl oor o nly, thus eliminating any distrac-
tion t o the p:llients. This is nro\'ided b\' either a surface or recessed box liht,
' !om-red to ;:dlo"- .l ighting (Fig. 9). - This system is ideal-for
pass:.1ges. out in large \\'a rds ,,here the bed posit ions are moved, the lighting
may he obscured. The fining must also be r obust as it is at a rather vulnerable
Je,el for d:1mage.
I
(e) Separale Ligll!ing.
Either smaller matching fittings or quite separate designs can be used. The
chief objection is tha t the fittings do not a]\,ays marry up with the appearance
of the general ward lighting.
(_() Din11ner Con1ro! on Bed Lights.
Although expensive to install. this does ail ow the staff to turn up the brightness
to inspect individual patients (Fig. 10).
l\ight S taff
T he night nurse must be provided with adequate light whil e wri ting reports
in the ward, but at the same time be able to adapt her Yision to the surrounding
low-Je,e[ lighting. T he desk lamp must provide no glare, and the use of red
materials will assist the nurse " hen working under the contrasting illumination
JeyeJs.
PRACTICAL ILLU\II NATI0:--1 ?\IEASUREMENTS 27
Other Lighting \
Coriidors.-Illumination levels should generally be between S to 7 lumens per
sq. ft. It must be borne m mind that a patient on a stretcher will often be-look-
ing straight at the ceiling and so open-bottom designs should be avoided. Night
lighting must be provided but of a higher level than in the wards. It must
also be evenly lit avoiding any dark patches.
Cupboards.-Many of the cupboards require good internal lighting. especially
those used for storing medical equipment. If the cupboard is in the ward.
the position of the light should oe concealed to avoid an excessi,e amount of
stray light being thrown across the ward at night.
Outpalien! and Casually Depamnems. -A hi gh le,e] of illumin:nion should
be available, supplemented with :1djustable inspection lighting. Tile use of a
large number of lower wattage g!Jre-free fitt ings is best suited for this -area, to
.enable work to be carried out in a ny part of the room. designed
ftuorescen; lamp fittings have pro,ect most sat isfactory.
Swff Quarters.-It is essential to proYide cheerful relaxing lighting in all
off-duty rooms. The designs shouid be quite d ifferent to those in t he working
areas, ample use being made of col our and modern designs. Illumination
levels should be at least 7 lumens per sq. ft. in the dining-rooms and
rooms, with more subdued light ing in the lounge and bedrooms.
Ki1chms, Sluices, and Clinical Rooms.- The most important area is often the
sink and lighting should alway? be positioned so that a person at the sin k does
not work in his own shadow. Damp-proof fitt ings wit h either chromi um or
porcelain carriers are recommended. and they should be out of the r::: :1ch of a
person workin at the sink.
There are m-;ny areas ejch requ iring special treatment. but these Y3ry from
one hospital to another. Pro\ided that the lighting is always adequa te. the
fittings well designed and constructed, and the layout pbnncd to suit the work
carried out, then the hospital engineer will have prO\ ided lighting to meet all
normal requirements. It is not the purpose of this chapter to de:1! wi th those
which are abnormal.
D. C.P.
PRACTICAL l\IEASl.' RE:\1:'\TS -1
For all p ractical illumination measurements the popular photoelectric light-
IJ:!.eter has replaced the older vi sual methods. -
. In its essentials the rectifier photoelectric cell consists of a copper, steel or
Iron plate upon which a copper o:-:ide or selenium film has been formed. Con-
are made on this plate and on the thin transparent special metal coating
Which covers the oxide or selenium film. When liht strikes the boundary sur-
face between the copper oxide or selenium and transparent metal coating,
an electron ftow is inaugurated which passes throm:h the external circuit and
deflects a moving-coil microammeter. Current, and- hence deflection, is almost
28 ELECTRICAL EQUJP\IEI'T
- J I Tl l ELECTR:JN
f FLOW
,s }A

II c:hJ
C D '---/
' .
-- 3ARKIER
fiG. II.- SECTIO'-' OF RECTIFIER
PHOTO-CELL (\"ot to scale).
A. Collecting ring: B. Trans-
'pu:nt metal: C. or
coppu-oxide: D. Steel or copper-
piJte.
ftG. 12.-TYPIC.-'.L POCKET
LIGHntETER ,
stric1ly ro the illumination provided that the instrument's resistance
is fairly low (not exceeding .:::00 ohms). The scale is. therefore. evenly di,ided
unless special pole shoes are used for the microammeter.
J\!:J.ny manuLcturers market compact. sel f-conwined lightmcters, a t ypical
cx3mpk is sho\rn in Fig. 1 .::.
A feature of tni s type of meter is the fact that the response Y3ries with different .
types of light source. are normall y calibmted with tungsten fibment
lamps operating at colour temperatures of 2,700" K. unless otherwise speciiied.
To m:Jl.;c allow:.mce for lhe different responses, correction f:!ctors are 3pplied
to the meter's inci ic3tions. .-'\.s the spectral responses of cells Ya ry over a wide
range 1:1ccording to the manufacturer) it is essential to ohtain the fact ors direct
from the supplie; or m:muf:Jcturer. Typical examples of correction f2- ctors
sho\1ing this \\'icie cii\'crgence are given in the table below. The meter readings
are mul!iplied by tile factors shown.
Li?hi Source
Tungsten .
Mercury discharge
Sodium discharge
Low pressure gas
Fluorescent tube; tdaylight)
Natural daylight
T ABLE IV
FACTORS
I
Selenium-Iron Cell j Copper-Oxide Cell
1-45
135
] ]
1 05
1
1
117
1-43
108
095
08
PRACTICAL MEASURB!ENTS 29
With certain types of cell an appreciable error in the measure_rnent of general
lighting can occur due t o the fact that the cell is protected from mechanical
injury by a glass window. This window reflects a propor\J:ln of the light which
would otherwise fall on the sensitive surface of the cell. Readings, therefore,
tend to be low, especially when the light .reaches the cell at high angles of inci-
dence. The graph (Fig. 13) shows the degTee of error which is to b= expected.
that if readings are to be correct irrespective of angle of inciden:e, the curve
would follow a cosine function.
When taking readings with photo-cells it should be remembe:ed that the
instrument ind icates the illumination on the plane in which the c=ll's surface
lies. Misleading results may occur if this is not borne in mind. ::s in many
cases the ill umination \'aries to a considerable degree for sl ight cha::ges of cell
position.
General lighting is usually measured on a horizontal wit 1 the light
'
106
80
::;
c
i]
I
.

I
""
I
-
I
1
0 i.:. 20
,
Of: IN DEGREES. ------
FIG. 13.-EFFECT OF Al'GLE OF ]
unobst ructed, so that care should be taken not to let the cell be screened by
any part of the body. When testing the light a\'ailable on a mach in=, however,
the operative should adopt his normal working position. If an a':erage value
is required a fair number of readim<s should be taken so that the eflects of new
or old lamps, which may be in use. -are cancelled out.
Whilst li2htmt>ters are usuall\ housed in robust cases it should be remem-
bered that 7he micr oammeter i; relati vely sensit ive and also that only a small
scratch on the cell's surface is sufficient to short-circuit it and render it useless.
Apart from obtaining check f!gures of calculations the lightmeter finds
great use in determining when the illumination has fallen to such a level as to
req_uire reflector cleanin-g and relamping. By the regul ar use of a lightmeter a
mamtenance en!!ineer ca.n draw uo a cleaning sched ule which ensures the most
use of labo ur and also. obtains maximum light output from the
Hghtmg system.
30 :'I!EDICAL ELECTRICAL EQlJJP\fE:-\T
SHADOWLESS LIGHT FITTI:\GS J
FOR THE OPERA. TL"G THEATRE
By E. A. SMITH
The terms, Shadowless Lamp, Shadowless Light, Theatre Fitting,
etc. , are w all members of the hospital staff whether technical , or
admini s:r:::. ti\'e, but it ,,ould be helpful if we afl used the terminology usual with
lighting engineers.
l. Lamo.-Refers to a filament lam;:> which is known to the public -as a
,. ,. . bel b .,_
2. Ti1t> Light Fiiling.-This refers w t he complete assembl y wl-1-rch
froc;; the ceiling and includes the unit , and t he suspension gear.
3. Light !1/lcnsirr.-Is expressed in Lumens per sauare foot. thus, or
lm. sq. ft. These are sometimes re:-e rred to as Ioot c:.tndies.
-4 . Jh, Light Fie/d.-This is the are::. ill uminated by the light fining. It is
usc:ally assumed to be circular the size is giYen in inches diameter.
Tht.: n:..:rpose of the light fitting is to illuminate the site of the operation.
As thes;; , ary from deep ca,iry with small incisions. to large surface areas
withou; :-n uch caYity. it can be seen th:>. t the fitting must be spe::: i:.!lly designed
and During an there is usuall y a cluster of he::1ds
and h;.tr:ds. Jround. and OYcr the patient . as most of t he time four or five p.:: oole
will \\or king as a team. Til ::: se heads ar: d hands tend to blot out
much of the light, and because of this the shadowless light fitting was designed.
\\-hen purcha-sing J light fining for the t heatre the following points should
be borne in mind. .-\part from being shadow free, it should be co..Q}jfl_us0J_av-
ing sQm'-. form of heat filter. The suspension must be flexible and coumer-
balan:ed. not relying on locking devices to keep it in position. It must have
focus 2ci_iustment, and for preference a number of filament lamps as the light
source, rather than one lamp with twin fil aments. It must be totally enclosed,
and Jo,, YOltage (24 , -olt) is better than full mains \Olt2.ge.
the heat is radiant it cannot be overcome by fining fans. and
the normal method is to fit a heat-absorbing glass fiiter round the lamp so that
the refiected light. "hich shines on the surgeon's neck and causes fat igue, is
cooled at its source.
MAIN TYPES OF SHADOWLESS LIGHT FITTINGS
There are two main designs of shadowless light finings. One is the large
single refi=ctor having a single-filament lamp as the light source, and the other
ha -,' ing a number of reflectors mounted together into a cupola, each one ha\ing
its own filament lamp. The latter system is the latest de\elopment, and a
OPERATll'G THEATRE SHADOWLESS LIGHT FITTI?\GS 31
natural outcome of the older style. There are several well-known manufacturers
who have been producing first-class fittings for twenty-five years or more, and the
illustrations shown in this section are by courtesy of them.
Single-reflector Light Fittings
Taking the older method first we find that there are again two types cif single-
reflector fittings , one being made from spun metal and using the polished and
plated surface of the metal as a reflector, and the other ha\ing the reflecting
surface made from a number of small mirrors mounted i_rno a cupol a.
Metal Refleclor T1pc.-Fig. 1-i shows the method by which a shadowless
light is obtained. It can be see-n that a reasonable diameter is important. and
it is generally considered that not Jess than :!.7 in. or is desirable. Fig. 1.5
shows a typical brass reflector light fitting. This consists of a :!.S-in. spmnmg
I
' '
, I
FIG. THE METHOD BY
\\'!-liCH A SH-'. DO\I' LESS LIGHT IS 0BT.->.I-.;m
& Hughes, Lid. )
heavily plated, and polished on the inside to a mirror finish.- It is so designed
that the light is reflected at a wide angle, and the lamp is screened behind a
deflector plate to avoid dare. All the available li!!ht is reflected downwards
to the field, and no matt;r how fa r under the fitting- the surgeon outs his head,
he cannot obscure all the light. The ligJ1t sou rce for this fitting .is a 1.50-watt.
24-volt filament lamp, with the glass em:tlope li ghtly etched to p;event striation.
The focus can be adjusted by sliding the lamprJOider into different positions in
the vertical plane and locking it there with 'a knurled knob. To obtain the
hJghest possible light output,-and at the same time avoid using nigh wattaf'e
lamps with their great heat, a dioptric lens is mounted on the defl;ctor pla;e.
'.!EDICAL EL ECTRICAL
SPJ:---:--1:--:G
( ;..:t>ldn & Hugius. Lld.)
FIG. 1 6.-RIGID \li RR. ORED
REFLECTOR LiGHT frTTi>,;G
WITH 35-I:--:. CL:POLA
(T!'cimical Ligi'::s ({ Co .. Ltd.)
Tim lens ::oilects all the avai labie light and p3sses it in parallel for m to the
refiecting surfaces.
A. further developrr.ent in light fittings of tn:s type is tne use of low voltages.
It is usual o operate a modern fitting on YOlts throug;, a which
gi,es a hi gher safety fa ::wr from tne point of ,-jew of eie::tric shock. and at the
s::.me tirr.e produces 2 whiter light than when using full mains YOltage at l 50
Wert .
It js also necessary to provide an emergency lighringsystem in case of mains
failure, and with this type of fitting it is done oy havi ng three additional lamps
mounted outside the dioptric lens and powered by a set of batteries, or a
ger:eraror. A mains er.ergised relay is used to gi,e automatic change-
o,er (s;:e se:: tion on err.ergency li giuing).
Singie-rr_fenor Firri1?g r..:sing Sn;a/1.\firrors.-The secor:d type of light fitting
":1ich uses the single light source system has for the refi e::ting surface a number
o: small .-r.irrors. These are moun red into an outer cupolc.. and set in a circle at
r:-:e correct ar.gle to gi,e maximum reflection. The are fixed edge to
OPERATII'G THEATRE SHADOWLESS LIGHT FITTI!'GS 33
Ftc. 17.-36!'-.. . DJA\tTER
MCLTI-REFLECTDP. 0PER-
AT!'.;G LJGHT FlTTl'.;G
edge and vary in number from 40 to 60 according to the diameter of the outer
casing. This wili vary in size wit h the model but 27 in. to 35 in. is normal.
The light source is a 24-volt, !50-wart lamp mounted inside a diopt ric lens. 1 n
these models the lens is made from a special heat-absorbing glass \1 hich acts as
a heat filter. and colour correcting medium. Emergency lighting is by additional
filament lamps mounted outside the dioptric lens. fig 16 shows a 35-in.
diameter mirror reflector fitting. This particular model has in addition to t he
normal shadowless .light, twin tilti ng mirror spotlights, and a remote focusing
arrangement by a control knob on the rim of the cupola.
\-Iulti-reflector Lioht Fittinos
0 0
T h ~ single-reflector type of fittings, both metal, and mirrored reflectors, have
been ~ active use for many years. and i't is a natural development. and improve-
ment In design that has brought the multi-reflector fitting into existence. The
system is to take a number of small reflectors, and mount them inside a lar!!e
cupola. These are then made adjustable so that the field, and light intensity
34 MEDI C AL ELECTRICAL EQUI PME NT
can be varied according to requirements. By this method the fitting is suitable
for all types of surgery.
Fig. 17 shows a modern mul ti-reflector fitting havirg five 10-in. reflectors
mounted into a circle. These reflectors are carefully designed and made from
super-pure aluminium. The s urface is specially treated and a mirror fi nish is
obtained which is impervious to atmosphe; e. The reflectors have a high
reflecting efficiency as well as being untarnishable. Each reflector has its own
Jig:ht source which in t his model consists of a 24-\'olt . 44-watt Britis h ore-focus
filament lamp. \1ounted round e::1ch la mp is a hexagon of of
heat-absorbing glass. These reduce t he radiant heat to negii gi0Je ouantiries
so far as the surgeon is concerned. The lower part of the cupola has five
windows encl osed with s::tfety-glass. The reflectors are mounted insi de this
spinning joust the windows. The upper pan of th<: cupola is re movable,
beir.g held in pi:1ce by four quic\(-rele:J.se catches. When this upper spinning is
removed, the inner part of the fitt ing is exposed and lamps and fil ters ca n be
cleaned. or ch::mged, wirh ease.
The reflectors are linked rogether to a conrrol knob mounted omsi de the
cupola 0:1 the rim. \\'hen this is tt.:Tned. the reflectors are mo,cd so, rh:J t the
light field is increJsed or decre::tsed. which in !Urn y;uies the light int ensity.
There is no ser. s:nion of heat felt by che surgeon on the back of his 3.5 the
heat fillers hole the radiant heat. :lnd. the metal in the fi tti ng itselC allows
it to dissip::lle t: pwards into the air. The filters are slightly coloured ::1nd act
as a colour system. gi,ing as near to daylight cond it ions as is possible
with artificial At a di stance of in. from the patient, bet ween 1.500
lm. and 2.000 lm . is obtained. \\hi ch is much higher tha n is possible
with a unit of the old type.
Fig. IS sho,,s a mult i-reflector fitting ,,ith reflectors and nine s}'ecially
designed !:.imps ::ach of wallS. Ti1e bmps themselves "ork 0n t he refl ection
principle. as the exterior surface is metJl lised in order to act as a mirror.
The reflected li ght from the lamps is again reflected by special refiec10rs mounted
in the fitt ing. ThiJ reflected light passes through two filters. one to improve
the colour of til e light, and the other to filter away the hea t. The electrical
layout is extremely simple, and connections are so arranged thar aD:, emergency
supply can be catered for by suitable series-parallel connections of low- voltage
lamps. A tr:::.nsformer steps down the mains voltage to the A.C. equi val ent of
the D.C. supply and the changeover relay, which is permanently energised by
the :\ .C. mJir.s. has contacts which will switch the fitting to the emergency
D.C. supply if the A.C. mains fail. The pirch of the reflect ors is adj ustable
and by use of the remote control knob, mounted on the rim of the cupola, it .
is possible to vary the field from 7 in. to 15 in. as needed. In addition to this a
uniform light is automatically regulated irrespective of the size of the operating
area. The centre reflector can be S\\itched out independently.
Comparison between Single- a nd :\ Iulti-reflector F itti ngs
Before describing in detail the various methods of suspension. it is worthwhile
drawing a comparison between single- and multi-reflector fittings. The single-
OPERATI!"G THEATRE SHADOWLESS LIGHT FITTI:-:GS 35
reflector models have the advantage that they are probably slightly more shadow-
free, but they have some distinct disadvantages, the most important of which
being the emergency lighting. \\. hen the single light source of a si ngie-reftecwr
fitting is changed by mains failure to the three or more emergency lamps outside
the dioptric lens, a different type of light field , and light int ensit y is obtained,
which in addition is rarely shadowles>. Should this happen at the critical stage
of an operation it can be extremely rrying for the surgeon. if not acrually danger-
ous for the patient. Further it is not possible to obtain st:ci1 hi gh li grn intensities
as with multi-reflecwr models. and neither is it so easy to pre,ent radiant heat
from affecting the -
FIG. 1 S.-NEW . St.:?ER 36-1"0.
;'11t:LTf-REFLECTOR OPER.HJSG LlGHT FlTnSG
( Sirrt'x, Lu!. )
The ad,ama!!es of multi-reflect or> are manY. and th is sr,le of fi ttin!! is bound
to be accepted -in time as the most suitable all kinds surgery.- This is a
particularly important point as most theatres nave to be used for all kinds of
operations, and by different special ized surgeons. It is generall y recognised
that between 1,500 lm.:lt.
2
and 2.000 is an acceptable amount of light
for a shadowless light fitting used for modern surgery. It is also important
that the light should be easily focused, and the field size ,aried. The multi-
unit has adjustable reflectors controlled by an e.'dernal knob. and it is a
Simple matter" to design this mechanically, by having a cable iinkage which
alters the pitch. The hospital engineer will not normally need to calibrate
the reflectors as they wi ll be set b\ the manufacturers at the facton. It is also
- -
36 MEDICAL ELECTRICAL EQUIPMENT
220-250-VOLT A.C.
24-VOL T EME:RCENCY
l l
{---y SWITCH
w
1 } SUPPL::Y
No.1
I
---T-----;
:
I
L- - ----- --

LAMPS
24v. 60w.
FIG. 19.-\ViRING DIAGRAM FOR SI,GLE
REFLECTOR, StNGLE MAIN LAMP
GENCY SYSTEM
Sprcijira1ion:
Relay No. I coil: 24 volts . A C.
Relay No. I contacts: S.P. change o,er
1 mercul) switch. Contacts rated at
I 0 amps .. 25 volts.
Relay No. 2 coil: 6 amps.
Relay No. 2 contacts: S.P. mercury
switch. open when energised. Con-
tacts r3ted at 10 amps., 25 volts.
cheaper to fit smal l heat filters, one to each reflector. than an optically worked
dioptric lens made irom heat-absorbing gl3.ss. A further point is that the lo11er
spinning. which has the windows. can be se::Ued against the intake of dust due
to the fitting breathing as the air inside it e:-;p::mds and contracts, when the lamps
are switched on and ofT: a ouiw.ble gasket can be fitted between the upper and
lower spinnings. and the entire unit made reasonably dust-tight. The single-
reflector linin!!. h011e\er. has a removable dass at the lower side which !! i1es a
dust the' most vulnerable point.- -
Perhaps the most attracti\e feature of the multi-reflector fitting is that the
light _field and light intensity does not Yary with the change from mains to
emergency supply, as the same filament lamps are used. The risks involved
by having filament failure of the only light source, are overcome by ha1ing a
large number of low-voltage and low-wattage lamps. Providing the battery
unit has sufficient capacity to carry the load, and is well maintained by the
hospital staff. it is unlikely that the theatre team will be aware of a
other than a momentary flick. Another point very much in favour of multi-
reflector units is that. providing it is designed with a suitable diameter, there is a
considerable space left in the middle of the cupola. and into this space can be
fitted all kinds of useful equipme:1t, such as cine, X-ray and television cameras.
It is the ideal position for this additional equipment.
Having dealt with reflector assemblies from 27 in. to 36 in. , it should be
pointed out that there are other sizes which may be needed in hospitals. The
hospital engineer may be asked to provide a suitable light fitting for any one
of a dozen uses other than the main theatre overhead light. The latter, howe1er,
should not be less than 27 in. in diameter. and 35 in. or 36 in. would be better,
OPERATING 'THEATRE SHADOWLESS LIGHT FITT11\GS 37
if .it is for major surgery. The jitting must
have emergency lighting, and a battery supply
giving not less than four hours running. If
a single-refl ector fitting is chosen, then the
reflector must ha\'e secondary emergency lights
even though the main lamp may be on 24 volt.
Thi s is to pr o\ ide against filament failure of the
main l:J.mp. The wiring diagram, Fig. 19,
shows how a suitable system-can be devjsed w
give auto>:1:nic. changeover to emergency in the
case of L: ii ure of the mains, or failure of the
filament. The normal method in this case is
w use the main 24-volt, I 50-wart lamp for both
mains and, when necessary, emergency, and w
use the secondary bmps for protection against
possibl e fii ament fa iiure.
If the hospital engineer is asked to pro\'ide
a shado\\ iess li gh t for anywhere other than
the main t neatre, then smaller si ze cupolas. or
reflectors will be adeauate. For the Casualty
Theatre ior ::'0 in. diameter would be
good enough. For obstetric work, a 20-in.
reflector mounted on to a troll ey base is often
useful. f o; Ear. !\ ose and Throat. a 13-in.
or 14-in. refl ect or t e a lightweight
ceiling sus;::ension is auite suit:J. ble. But con- FIG. 20.-\\'JRE SL' sPENSJos
sidcrati on must' be giYen to the kind of room or Ln BLI GHT F ITTING
the:Hre in wr1ich the light will be used, as these IA'ri"" & Hn;,crs. Lid.)
fittings are heavy, and ceil ings often
have to be braced to support them. For t his reason it is sometimes necessary
to use a light on a trolley base, but trailing cables are not Yery popular
with surgeons.
TYPES OF SUSPENS IONS
The next point to discuss is suit able suspensions and. as wi th refiector units,
development over the years has brought n{any imprO\'ements.
\\'ire and Pulley Suspension
The first type of suspension used, and still in use, is the wire and pulley type .
. This consists of stretching two or more wires over wheels fi t ted to the ceiling
and balan:::ing the reflecto; with a counterweight as shown in Fig. 20. The only
of this design is that it is cheap to buy, but like most cheap things,
It IS not particularly efficient. The wires, being exposed, are noto; ious dust
collectors, and the reflector has a tendency to turn on its side when being adjusted,
even though the suspension is fri ct ion controlled as well as counter-balanced.
38 ., MEDICAL ELECTRICAL EQUIPMf:NT
The Rigid, Telescopic Suspension
The most popular suspension in general use today is the rigid, telescopic
type, see Figs. 15 and 16. It can be seen that the cables which support the
telescope, and the electrical cables, are taken down inside the casing, and the
whole exterior is smooth so that little dust can collect. The drop rod which
gives vertical movemem slides up inside the casing when the cupola is in the
highest position. Apart from being in a position where they do not collect
dust, the electrical cables are also protected from damp when scrubbing down is
m progress . .
lt should be remembered ihat more damage is done to delicate equipment
during "cleaning than in normal wear.
Ceiling Runway
As the telescopi);. fittir.g is rigid . it does not swing when adjusted. alt hough it
has plenty of flexibility. Additional movement is obtained by attaching the
entire fining IO a ceiling runway, 11hich is sometimes known as a track.

. I
\ \
I ' FIG. 21.-TRACK
Ru:.:wAY
II


This allows, the fitting to be moved in the horizontal plane, and is less difficult
than moving the table and instrument uolievs. The tracks can be boue:ht in
varying lengths to suit the hospital, but for ;nost normal purposes six fe-et, or
eight feet is plenty.
The track has four small trolleys inside to which the fitting is connected by
bolts. These uolleys are ball -bearing mounted to give ease of movement.
Considerable c2.re should be taken to mount the track properly and to check
it 11ith a spirit lelel, as any gradient on it will cause the counterbalance in the
fitting to foul the side of the casing. The main objection to track runways is
that they collect dust and are difficult to keep clean. Moving the fitting in the
middle of an operation can dislodge dusL which might fall on the patient,
Cantile,er Suspension
As a natural outcome of these various suspensions we arrive at the latest
design which is the cantilever type (Fig. 22) . As can be seen movement to any
p oint over, and about the table, can be made in a second. All cables are internal,
OPERATING THEATRE SHADOWLESS LIGHT FITTINGS 39
fiG. 22.-CA'>TILE\"ER
. Sl!SPE'>SIO'> fOR OPER-
,\Tl'>G THEATRE LIGHT
fnTI'>G
(A"ehin d. Hu7hcs . Ltd.)
,._1-,
and starring from the ceiling we h.:ne the following assembly. The ceiling
casting which houses the sl ip-rings, allows the suspension to be moved
through a full circle \\ithout a stop, and without damage to any cable_ At the
bottom of the slightly cranked drop-arm, there is a hub \\ hich gi ves further
movement and allows the cantilever to move up or down. The reflector yoke
is jointed to allow sideways tilt of the cupola.
To give smoothness of movement. this type of 5uspension is perfectly balanced,
and at the same time has damping pads in most of the hubs and joints. These
pads can be tightened down periodically so that the fitting is always under
control, and does not "float" too easily. F onunately there is sufficient move-
ment in the suspension to make the use of a track rum,ay unnecessary.
PORTABLE LIGHT FITTINGS
When considerin light fittings generallv some attention mi!!ht be given to
the portable fittings: as- they are-a part of a modern equip-
ment. It should be made quite clear that there are two distinct types of porta-ble
40 MEDICAL ELECTRICAL EQUIPMENT
theatre lights. One is a shadowless light which is really a miniature of the 36-in.
overhead model, and the other is a spotlight which is not shadowless.
The hospital engineer would be well advised to find out exactly what the
surgeon needs, as there have been many mistakes made when ordering a portable
lighting fitting. A spotlight can be mounted 'on a trolley base, and usually
consists of a small reflector into which is fitted a fairly high-powered filament.
lamp. Generally, some form of lens system is used also; the resulting light
being a narrow beam which can be focused to a _very small field. and is ideal for
deep ca\ities and special work. ]tis not at all shadowfree and even a hand will
biOI out the light entirely. They are, howeYer, an excellent addition to the m1in
light.
The other type of portable is. of course. a smaller m Jdel of the 36-in. over-
head. The reflector will nry in size from about 13 in. to 20 in. and the light
output will ranrre from 500 Im./ft .
2
to 1.000 lm./ft.
2
Usuallv thev are of the
single-reflector having a sfngle-filament as their light But
there are models appearing on the market with multi-reflector cupolas g'i\ing
a higher safety factor. so far as filament failure is concerned. '
The Yarious models offered by manufacturers today, cover almost all hospital
needs. being for mains supply only; for battery supply only; and combined
ma ins o.:wery. The latter type have a transformer fitted to the base gi\ing
12 volts to the lamp. and a pair of batteries mounted on carriers on the bJse.
There is a sparkless switch which gi.ves manual changeover to battery on m1ins
It is possible to ha\'e a mains energised relay with a pon<:_ble fitting
10 gi ve automatic ch::tngcover. Figs. 23 and 24 show typical por,ables with
l <:! nd J 8-in. refiectors respectively.
The trolley p::trt oi the fitting is fairly simple. The reflector yoke is connected
t o a cross arm, or tekscopic arm and, as a general rule, the cross arm assemoly
is c0ur.::::rweighted. or attached to a sliding device to give vertical movement.
A. s with the overile2d light, the cantile\er is corning into general use, as it is
si mple and effecti\e. lt is important when considering a portable fitting. to
remember that it must stand well back from the table, bearing in mind the
number of people alre::tdy clustered around. To do this comfortably. the cross
arm must have plenry of reach. and the light be sufficiently powerful to be eflec-
tive when standing well back: a weak light with the reflector close to the main
column is quite useless.
The Trolley Base and Castors
The main column is fitted to a heavy cast base, the design of which is some-
what controversial. The main problem is whether to have three arms (and
castors) or four. If iour are used, the fitting will rock if the floor is the slightest
bit uneven. For this reason alone the three-armed model is superior as, by
the design. each castor must sit squarely on the floor no matter how uneven it
may be. Providing it is well designed and of sufficient weight it is practically
impossible to overwrn. When choosing a fitting particular care should be
taken to examine the castors. These should be of the highest quality, even
though' they cost a little more. Cheap castors are noisy, and do not run
OPERATI:\ G THEATRE SHADOWLESS LIGHT FITTI)';GS 41
FiG. 23.-PORT-\BLE OrER.\TI -..:G
TH,\TRE LIGHT G 1\ '1-..:G I.O:J::l
FT. C\-..;DLES ILLUIIS.\TIOS
(Trcilmcul Lrghrs d Eqmpmrlll Co .. Ltt!.,l
FIG. 2-1.-PORTAULE C0\11!1'<[0
\IAISS-E\IC:RGE-..;cy 0PERATI'<G
THEHRE LiGHT
smoothly cvcn when new. \\'hen a rc old. thev are an nbomin:nion. The
tyres on the castors must be m:1de o.f conducting rubber. or to usc the l:ltest
term anti-stJtic ...
Where a fitting h2s a of on the bJse it is worth,1hi le spending
the extra money and having the alkaline type, as these do not det eriorJte with
standing. and require practically no maintenance. Their long life compared
with their lead-acid brothers is alone wonh the extra cost. One further point
to remember when buying a portable is the height of the doors in the hospital,
assuming that it will be necessary to move the light from one ward, or theatre
to another. If the main column of the fittin -.! is so hih that the entire trolley
has to be tilted on its side to mJnceu\Te it ;he door, the fitting will
soon fall into disuse, as it is a most fatiguing quite apart from the risk
of upsetting the batteries.
MAl NTENANCE
Most manufacturers of repute \\ill send a technical representative to advise
the hospital engineer on problems of maintenance. 01 installation, and the
engineer would be well advised to use this senice rather than to allow expensive
to be damaged by inexpert senicing. NeYertheless there are occa-
Sions wb.en maimen2.r:ce can be carried out by hospita] staff quite successfully .
. I>
MEDICAL ELECTRI CAL EQUIP\!EKT
Cleaning Light Fittings
The light fitting can be-cleaned when the thearre has its normal wash down,
and the outside surfaces should be wiped over with a little soap and water, and
polished dry with a leather. Care should be taken that too much water is not
used as it might penetrate inside the fitting and cause damage. Under no
circumstances should ether be used as a cleaning material, as this has a tendency
to soften the paint, and shorten th;: life of the equipment. This is also important
if the windows are made from perspex. or some similar plastic material. There
c.re special cleaning fluids which can be purchased which clean and polish
perspex.
Cleaning inside the fitting is a serYice which needs care and attenti on. If
the reflectors are of the metal type and are plated they should be cleaned wi th
a little Si iYO applied with good quality cotton-wool and polished off with a
Sehette . Great care should be taken not to scratch the and under
no circumstances should any abrJ.siYe. such as brass polish be used. l f the
refiector does not respond to ti1is treatment. it is better to call in t)1e manu-
f:Icturers technical adviser.
lt is Yery rare that a spun br;ss reflector can be replat ed successfull y
as it is the most expens ive olthe fitting. it is well worth\\ hile treat ing it

The m:mufacturcrs ca n, hO\\'e,er, repolish mechanically. proYiding the re-
ficcwr sun-ace is in reasonably good condition to start with. It is Yitall y import -
an! th:H the reflectinr! surface is at the hir!hest standard of cmcie nc;y
as the light output will fall off r::pidly once filming is- allowed.
\\.here the ritting has mirrors as the reflecting surface. and this appli es to
all glJssware inside the it should be cle:J.ned with a clot h anci
chamois lc:Hher. and if it is gi\en a fin:1l polish with tissue paper there is no
p0ssibilit; of dirt being icft. Hc:H fil ters necd to be cleaned rcgubrly as fil mi ng
\ I ill cause considerable light loss. They should be gi\'en the same as
the mirrors. and if t hey are made in one piece this is qui te easy. Should they
be made from strips of O.J\.::0 (heat-absorbing glass made by Chance Bros. of
Smethwick). then these must be examined \\hen cleaned and an) cracked strips
repiaced. The hospital engineer would do well to hold a small stock of tnese
against damage during maintenance.
The most modern type of fitting of the multi-reflector type have reflectors
made from super-pure aluminium, which is electro-polished to a mirror finish.
These are probably the most efficient reflectors obtainable, and are quite
untarnish.::bie. i\faintenance of them calls for liht-handed staff as the reflec-
tors are very soft. and easily damaged. They sh;uld therefore not be touched
more than is strictly necessary, and then only wiped over gent ly with a Sel-
vette" or a pad of soft cotton-wool. Under no circumstances should abrasives
of any kind be used or the surfaces will be damaged beyond repair. Should
one of the reflectors be damaged or become badly marked it is easy and fairly
cheap to replace it with a new one. It is one of the great ad\'antages of the
multi-reflector fitt ing that the reflectors being small there is no difficulty in
replacing them from time to time.
OPERATING THEATRE SHADOWLESS LIGHT 43
Checking the Light Output
As standard maintenance, 1t IS 1mportant to check the light output with a
light meter calibrated in lm. jft.
2
The fitting should be set at 42 in. from the
table and the focus adjusted to give the maximum intensity. The results should
be compared with the makers' specification for the light. A small falling off in
power can be overcome by cleaning, but any large drop should cause the
engineer to start a thorough investigation.
The filament lamps therefore play a large part in the efficiency of the fitting.
Each type of lamp has a life gi,en to it by the manuf:1cu.:rers. and expressed in
hours. If this life is exceeded, the light omput per W:llt will fall rapidly. e\en
though the fil::lme11 t will not actually fail. The mai nte;;ance engineer should
mark each lamp wi:h the date it was installed, and estim:lte the number of hours
use it is gi,en per week. or per mont h. \\'hen the lamp has completed its life
it should be replaced. Only the correct type of lamp si10uld be used in the
filling, as sp:xified by the makers. The wrong lamp wili in poor light,
overheating
1
striation, and other faults. As a general rule pearl lamps are
used in most fittings to avoid striation. but sometimes the m:mufacturers supply
special types. and a stock of these should be held by the hospi tal. It is possible
to lit an hours counter to the control panel of the to keep an accurate
check on the number of hours run. This is a worth\\ hiie piece of equipment
which is not used enough by eQgineers.
Importance of Correct Yoltage
If the fitting is t he type operating on low voltage through a transformer. the
maintenance engineer should check that the voltage is correct. It is usual for
linings to be on volt. and it can easily be seen that a dror olts can have
a considerable effect on the efficiency. It is just as seri ous to o,errun t he lamps
by putting 26 volts through them. 3S this \\ill shorten the iife of the bmps and
upset the calcubtions of the m:J.intenance staff, even if th!"y are using an hours
counter. Most lamp manufacturers provide a graph showing how the life of
a particular lamp will fall off with tile increase of voltage over its normal rating.
Inspection of Wiring
Maintenance of the wmng in the fitt ing should not cause any difficulty.
Where electrical cables are taken down inside the fitting some stress to the
cables may occur. An inspect ion should be made periodically for fractures in
the insulation, \\hich usually occur where the cables pass tnrough trunnions
and similar joints. This applies in particular ro the camilever-rype suspensions,
multi-reflector units. The problem has been well considered by the
aes1gners, and proper inspection plates provi ded . . It is therefore only necessary
to remove the inspection covers as indicated in the instruction book provided
by the manufacturers. and check that the cables are free and undamaged.
Adjustment of Joints
\fost modern adjustable fittings are counterbalanced, but to prevent excess
movement and float .. , the \'arious joints are by the use of friction
-+4 ELECTRICAL EQUIP\1E:--:T
pads. On the older type, wire, and rigid fi tt ings, this is done by having a p.:id
of fe lt lu'ori cated with oil pressed against the main pulleys which carry the sus-
pension cables and counterweight. Should the movement of the fitting prO\e
too fre;:. and loose. it is a simple matter to remove the cover from the main
column. and tighten down the friction pads: this is a simple matter with a screw-
driver. . Should the pads be worn, or too ciry, they an; easily repbc;:d, the work
c:m be done in the theatre in half an hour.
\\ ith canrilewr suspensions. the trunnions and fiexible joints have lcrge
bearing su;laces. and a g!Jnd which is easil y tightened down with a "tommy-
03r This is p:uticubrly useful to the engineer. as the fitting can b;:
Jdjusted .. stiff" or "loose., according to the \\'hims and fancy of the staff us:ng
the thc::trc.
As u general rule, the modern htting has a slip-ring assem >ly
mounted in the ceiiing to give it all-round movement \\ithout the use of a stop-
ping de\ icc. This assembly should be occasionally and cle;tr.ed . .
If the b;ushes show signs of \\ear they should be remO\ed :1nd replaced hy ne\v
ones surriied hy the manufacturers.
Fin:Iih. it should be remembered that a modern iitting is a complicated
piece of equi oment. and not a simple reflecror with a fiiJ.ment lamp in the
:l' 11':1<; Lh2d ti\CI11:-fi\e years ago. The staff. excellent a5 they arc :.Jt
t heir own \\ ork. are good engineers. and the hospital engineer would b.::
II'Cil :1d1 is::d to them aii':JY from the iitt ing altogether, or if one of them
G10:tblc then gi\e him. or her, prop:: r training in maintcn::mce. ;\lore
i" dcn:c to couipmcnt h\ O\er-clea r.i r' g than hy years of ordinary use.
\\'ith thi s in mind it is vital ly import ant to keep out dust. and preYent it
sett ling on the reflecting surfaces. The cupola \\ill breathe in use: this i:; caused
[ly 1hc c:-:n:1nsion and contraction of the as the lamps are S\\itched on and
off e:Jch d:l\ . Although a thc::tre is spot lessly clean, some dust is th roll'n up
rrom bL.:nkets and clot hes which will be su::: ked inside the cupob. To preYent
this h:!ppcning. some fittings :tre fitted \\ ith air Alters. and ha\e gaskets set
between !he lower and upper spinnings. lt is most important that \\hen
mainten:1 nce personnel have seniced the fining, the gasket is replaced in its
proper rosilion. Should the gasket shO\\. signs of wear, it should be renewed
by one supplied by the makers of the equipment.
\\'here the fittin g has an adjustable focus. the theatre staff should be instructed
in its use \\hen the fitting is installed. if they are to get the best possible results.
:\Jaintenance of Portable Lights
The main tenance of portable operating theatre lights does not vary much
i-rom the oYerhead models. With the type powered from the mains, either
c irect. or through a transformer. the main cable between the portable and the
power supply should be checked regularly to ensure that it has not been fractured
'y someone pushing a heavy trolley over it. If it is plugged inw the mains in
: ne the:! tre, then the S\\itch-socket \\'ill be of the sparkless type. But care should
oe taken that the plug top is properly connected to the cable at one end. and
, ,at i is secu;e \\' here it connects to the fining itself. This is most important
,
OPERATING T HEATRE SHADOWL ESS LIGHT FITTI:\GS 45
as a bud joint can cause arcing, and the possibility of an explosion, if the equip-
ment is used in an atmosphere where explosive anaesthetics are being gi1en.
If a switch is fitted to the trolley, it will be of the mercury type and, therefore,
sparkiess, but it should be inspected freque ntly to make quire sure that it has
not been damaged. Where the portable has combined m2ins and emergency
lights. it will have either a mercury switch, or a mercury relay. The relay 11ill
most likely be of the mains energised type to give autom:nic ch:1ngeol'cr on
m2ins failure. This should be checked by s11itching on the unit and ti1en
cutting the mains. l\:eedless to say, the battery supply must be of the highest
stand:::rd. preferably of the alkaline type.
SAFETY PRECAUTI ONS
There are two main risks in operat ing theJtres where any equipment
is used. One is dectr ic shock. and the other explosion caused by a sp:trh:
igniting an anaesthetic. This be c:JUscd by faulty eq uipment or a st:llic
charge teing rcleJscd to earth. As v.e are only concerned v.ith light fillings in
this section. the risks i1wo!vcd are snnll pro\'iding reasona ble precautions :trc
taken. The Institute of Electrical Engineers publish a bookkt \lhi ch co1crs
\\'iring recommenda t ions, and there is no need to enlarge on this side in this book.
The \!inistry of recently reco mmended that ck:trical apparatus
used in hospitals. should, where posslbie. be designed lor !01\ 1olrage. \\'ith
lighting equipment this is easily do1:e. :tnd is in fact a n adl'anuge in many
respects . The transformer supplying l'he filling is usually mounted on the
c:':iling. or in a loft above the theatre and th erefore be touched hy ;u1yonc
in the theatre . The fitting working on:! suprly docs not present a risk
so fa r as electric shock is concerned. Portable equ ipme nt more careful
thought, but,there is no reason why 12-\olt or 2-l-\olt cannot be used. If the
transformer is mounted on the base of the app::narus: then the mo. ins cable 11 ill
need to have a proper cable-rerainer to prevent it being pulled out hy someone
using it as a tow-line. If it is powered direct from the mains. it 11ill be fined
\\'ith three-core cable by the manufacturers. and suitably earthed. Some
engineers fit mewl -braided cable as an added precaution. and as most manu-
facturers supply the cable t o order in the fi rst instance. it is not difficult to state
a preference.
Static Electri city
There has been much vritten about st:J. tic electricity, and the dangers con-
nected with it. The light fittin is one of the lesser offenders in the theatre. but
certain precautions should sti ll- be. taken. lt is generally accepted that when a
stat1ccharge has been bui lt up on a piece of equipment. it is desir:tble to pre-
1ent It being flashed to earth 11hen a cerson standing on an ordinary floor
as a trigger. this in mind.' operating the:J.tres ha\e special floors
allow a slow leak to earth haYin e: a resistance of 2 me2:ohms.
trolleys, and simibr eq uipment have cond-ucting rubber tyres on caswrs
-l6
ELECTRICAL
to encourage this slow leak and pre;,-ent a charge building The boots worn
by the theatre staff are also made from conducting rubber. With other theatre
equipment the problem is not so easy, but \\;e -are not concerned \Vith ti1is here.
Genc r:!lly, fittings are ena melled and the thin coating of enamel will act as a
semi -insulator and pre\'ent a quick flash to earth of a static charge. Fortun-
;Jtely. the use of hi2hh exolosi\e anaesthe tics is on the wane. However. care
must be uken. and-i(t he being used is in doubt, then the surgeon,
and an:lesthetist must be informed. and a safe !:':as used.
The entry of anaestheti c gas into a light fitting. and an explosion occurring
because of it. is possible but extremely rare. But to design a fitting which is
flame- ::md flash-proof w Buxton Certificate standards is well-nigh impossible.
rrnd there are certain]\ none made i n this countrY. The best which can be
done is to make the equipment reasonably gas-tight and mount any doubtful
parts not Jess than 4ft. 6 in. from the floor. It is accepred that hei!:':hts above
this :tre Ltirly free from anaesthetic concent rations. The fittings h:1ve
good Iightjoints. and be total ly enclosed with glass. or simibr m::ue r ial. Gaskets
can h.: employed when j oi ning two sections together. hut one side of the j,,int
should h:ne rhe !:':asker m:1cie fast ro it. as a loose !:': asker em be left out \\'hen the
fiuing is hy inexperi enced people.- S1\irches must he
and :ill wiring connecri ons \\'ell made and secured. If the O\t rhe:td fi lling
is dcsie!ned. so that it cannot he swum! lower than -l ft. 6 in. from the floor.
then :t-gL)Cld de:!l of rhe r is k of cxnlos ion is as a conccJl!rJti on of
an;:.:stilctic gas :: tbo,e 4 i t. 6 in. \\' 0 uld present a sorry future for the tc:Jm of
pcopic 110rking in the thc:.:tre.
S1\it..:h sockets in the rhc:.Jrre musr be fl3shproof: if there is any doJbt ::1bout
the clcctri:::al sJfety of a piece of equipment. rhe makers technical representative
should cali:::d.
THE AUTOMATIC COLOUR CAMERA
The multi-reflector light fitting is designed with a space in the centre, into
which can be fitted a camera. This camera unit is usually an optional extra,
but the nrious manufacturers who are offering such equipment have their
fittings re3dy rigged so that a camera assembly can be fitted at any time. This is
panicubrly important for the hospital as they may wish to divide the cost of the
total apparatus so that it is spread over t\\O financial periods.
The unit referred to here will be a still camera designed to take first-class
colour pictures every few seconds without the need of a skilled photographer
being in :.mendance. Thi s is a form of automation which is becoming a necessity
in the theatre. \\'ith the camera mounted in the light fittin!:': there is no inter-
ference with the operation. and no danger of b; h:::tving someone
leaning o\er the patient to take a photograph. The colour transparencies
which 3re produced can be mounted into slides and projected to many times
their normal size so that the surgeon can study the subject thoroughly at his
leisure. There are numerous occasions when a surgeon would like to take a
OPERATJ:>:G THEATRE SHADOWLESS LJGHT FJTTJ:'\GS 47
FIG. 25.-SHOWISG T;; :o At:T0-
MATIC (OLOUR UKIT
FJITED TO A MULTIR!:FLECTOR
LIGHT F1rr1-..:G
l A"rh-in & fiughrs. !..Jd.)
picture but obviously the patient cannot be left while a search is made ror a
suitable photographer.
Film Size
The general principle followed by most manufacturers is to take a standard
camera body made by one of the many well-known carr.era manufacturers, and
adapt it to their own needs. It is usually agreed that 35 mm. fi lm is most
suitable, giving an exposure size of 36 mm. >( 24 mm. which lends itself to
mounting in standard for projection b) any of the well-known proj ectors.
Small lightweight slides of this type a re cheap to prepare, and easy to store, or
send by post and airm<:.i!. It is now possible to buy colour film for the 2 >: 2
camera and it is not di:Ticult to fit such a unit , but the extra cost of the larger
film is quite unnecessary as 35-mm. film will enlarge up admirably.
It is usual to have a fixed focus of 42 in. for the camera, and to offer various
lenses suitable for CO\ering all subjects. The size of subject will Yary from a
large incision in an aodomen to the corner of an eye. Naturally any type of
lens can be fitted, and interchanged, and they vary from a 1 0-in. telephoto to a
24 m. wide angl0. It is hoped that the Lnited Kingdom manufacturers will
shortly offer one standard lens which will cover the entire of subjects.
The Sa\ing in cost is co" siderable. Where a number of lenses a; e suppl ied the
manufacturers will pro\ ide an instruction plate giving details of which to fit
48 \IEDICA L ELECTRICAL EQUJP'.I E :-.JT
for various subjects, and allow inexperienced hospital staff to operate the
camera.
Electronic F la!:h Tubes
It is, of course, necessary w get perfect colour rendering, and this me:.ws
oreful babnce of avaibble light. To avoid interference from theatre
li ghts. etc .. electronic fhsh is used. J'\ormally three flash tubes type SF 20
are fi ued giving a total of 600 J o ules. This is more than eno:.Jgh to swamp the
main iight. and dayli ght. TJ1e SF 20 flash h:l\e a life of approximately
10.000 flashes. and to prevent any risks to the patient they are enclosed behind
windows .of the fitting in addition to being totally enclosed themsehes.
The tubes :::re powered by a condenser p.1ck ll'hich is mounted either on the
ceiling. or some11i1ere high up. and out of the 1vay.
The 11iri ng of the CJmera is so arr:1nged th:l! shoJJj the ii:c'1: JJ!ling be on
.. emergency" ti1 en the c:::mera c:tnnot be operate-d.
Camcrn Control Panel
The control p:!ncl for the camera is mounted on the the::tt re \I'Jll above the
..: -ft. 6-in. limit. and houses the charger unit for the coJ>dcnsers. and s und ry
other pieces of app:!rarus. On the out side of the pJncl is the milin
switch fo r the light. the s11itch for the camera. and the push-button 11r.ich
triggers off the shutter. and synchronised flash. There are l\\'0 ll'atning lights,
one 10 show lint 1he appar:nus is .. on .. and the mhcr to warn the o perator that
the conde!!Sers :ere charged. The time intenal between exposures ll'i ll
11i th differe:1t m:1kcs of but som::?11hcre het11een 5 and 20
second;: i' nornd . Thi!' time bg is only to all011 the condensers to reci1:1rgc
ful ly. ::nd a de1icc is ii !led 10 prel'ent . the fl ash bci ng made before the
maxim:nn p011cr is a1aibble. It is u;;ualw fit a fo:a!-plane shutter. and this is
rci\OUI'd automaticall y Jt the same time 2.s the spool is mowd up for the next
exposure. Ope<ating the camera therefore, requires no skill and anyone in the
theatre can be instructed in a few minutes .
. general rul e. the following pro:edure would be carried out. The
would be loaded with film at the beginning of the day. or between operations
if the spool has oeen completed (an exposure count=r is available). The light,
and camera are s11i tched on. and the C3mera adjusted for distance and centre.
This is done by a speci al r angefinder and as the fo:us of the camera is -E in.
it is the s::tme distance from the patient as the light would normally be set
\lithout a c2me;a. The operation can then follo11 its normal course without
any interference. When a photograph is required. the surgeon simply moves
his head back so as to prevent the lens from being obscured by his head. He
then gives instructions for someone to press the bu!lon on the wall, and the
picture is taken. .-\t the same t ime the camera is prepared for the next shot.
" Dam-busters " :\Ieth od of Camera Focusi ng
The main difficulty in designing this type of camera unit 11as to find a suitable
method of focusing at exact ly -i2 in. which would be simple to use. \\.hile
EMERGE:-;cy SYSTEMS 49
this can be done by the split image type of prismatic rangefinder, or by the
12:round-glass screen as used in a reflex camera, neither of these are satisfactory
for the operating theatre, as they are too difficult to use during an operat ion.
The accepted method therefore is an adaption of what has become known as
the "dam-busters" rangefinder. This consists of two lights mounted on the
underside of the fitting which throw a coloured light on ro the field, or
an image of the fil:lment. These are calibrated to cross, or superimpose when
the fitting is at exactly -!2 in. from the patient. It is a simple mJne;- to raise or
lower the fitting until it is in focus. \\"he re filament images Jre used t hese
when crossed show t he centre as well as the correct focus. 1 t is generally
necessary to dim the main light to carry out this simple focusing system.
Using this per fe ctly simple method of focus adjustment, and the com?ierely
automatic camera. it is possible to take perfect colour pictures of operation
includin; deep ca\ity, without the need of a skilled photogrJpher being :n the
theatre. The of the camera should cJuse few to the
hospital staff, as the casettes can be loaded in ad\ance by the photographic
department or, where no department exists. by anyone with Jn ekm::nury know-
ledge of camera \\ orking. The could be cileck;:: d from time
to time by someone used to electro-medi c::ll equipment. i\!o;r
of this type of equipment hJ\e 3 maintenance staff of S:'?nicc cnt=inecrs
available in all pans of the country . . The hospital engineer \l ou ld do 1.ell to
raise this point \I hen buying equipment of this kind. if an :1ppar:1tus or
forE:1gn is con tempbted.
The flash tubes \lith their life o( 10.000 flashes should give no ir Ottblc. T hey
are standard tubes and can be in the fitting as easily as J fil:!mcnt lamp.
The film itself is normally processed. and the tr:rnsp:m: ncics mounted as slides
by the makers of film: speci<JI schice can be obtained for md ical fil m if
requested. There are also films on the mJrker 1\h ich can b:? by the
hospital photogr::phic department.
L\IERGE;\CY LIGHTI:\'G SYSTE\IS J
By E. A. SI\11TH
It follows from the previous section on Shadoll'less Light Fittings that some
form of safe stand-by battery unit is necessary, even in the sm:li est hospital.
The ideal arrangement would be to provide emergency lights everywhere:
wards, corridors. staircases etc. Unfortunately this cannot be done with
batteries without considerable cost. and technicaliy it is a job for an e'mergency
power. plant rather than for batteries no matter how good thev mav be. Jn
this chapter, therefore, we are concerned only with a;d battery type
emergency systems. in which main emphasis is placed on the operating theatre .
. _There are various ways in which the hospital engineer on provide his hospita l
WJth emergency lighting. One is by buying a set of batteries and designing a
50 MEDICAL ELECTRICAL
system to suit his theatre; the _oth:r is by installing one of the standard systems
designed by experts and offered complete in every detail.
\\"e ha\'e seen from the section dealing with the design of light fittings for the
operating theatre, that the multi-reflector unit uses the same filament lamp
both for mains supply and for tile emergency supply. (The former usually
being transfomed to 24 YOits.) The advantage of this system is that the surgeon
does not ha\e a \'ariation in his i!ght field, or intensity, when the mains fail.
Ti1is has to oe borne in mind designing a suitable emergency system,
as hospitals still have the o!d design of light fitting which uses a single
lamp as the main light source. ar.d has three auxiliary b:J.ttery lamps to cover
of the mains or fusing of tf:e filament.
If effecti\e eiNrfency lighting is to be provided. irrespectiYe of the type of
light filling t.:sed. certain other cor:ciitior.s must be fulfilled:
I. and automat ic operation of the emergency lights, in the
e\'cnt of mains failure, and " here c::pplicable, filament failure.
,
FJG. 26.-SECTJo:--; THROUGH .. C.LL
EMERGE:-:CY LIGHT!]';G SYSTEMS 51
2. The lighting in a key point such as the theatre must be continuous and
of sufficient duration to allow a long operation to be completed.
3. The light power of the fitting in the theatre must not drop appreciably
when being run on batteries.
4. The emergency lights must be switched off automatically when the
mains supply is restored.
ALKALINE BATTERIES FOR EMER :;ENCY LIGHTING
There are two main types of batteries in use generally today. One being
the alkaline, and the other the ordinary lead-acid: each one has certain ad\':Jilt-
ages, and the final choice is usually a p::rsonal
one.
Taking first the alkaline battery. the' flat
plate cadmium,. type is recommended where
the battery is subject to long periods of
idleness. In addition to the general char-
acteristics of physical and long
life, which are common to all typ::::s of
alkaline cells, the flat plate cadmit:m battery
is virtually free from self-discharge at normal
temperatures, and its ability to hol d its
charge for long periods renders it ideally
suited for stand-bv. and emer!!encv work of
all descriptions. -Except , th;ref for an
odd boost from time to time, it does not
need recharging unless it has been used in
an emergency. It is 'Jsually charged at its
not necessary.
Construction of Flat Plate Alkaline Cell
FIG. ::I.-FIVE FL\T PL\ T[ C.\D.\lll' M
CELLS IS lsSL'LATl'<G CRAT
Baucrics)
full rate, and trickle chargers are
The flat plate cadmium cell has the active materials enclosed inside flat
perforated pockets made from steel ribbon, these pockets being assembled
horizontally in an outer frame and so that each pocket is firmly
interlocked with its neighbour. -
The positive active is nickel hydrate with the addition of an inert
carbon to improve conductivity. The negative active material is a mixture of
finely. divided iron and cadmium. The plate groups are assembled in a steel
contamer with one more positive plate than negative, and the pbtes are insulated
from each other by means of rods (fi g. 26). The cells are effectively insula ted
:rom each other and from surrounding metalwork by suspending them in
msulating crates, by means of bosses. being supported in rubber insulators
recessed into the side rails of the -insulating crate (F1g. 27). The
.52 :.!EDICAL ELECTRICAL EQUJ P!\! ENT
::
0
. .
FIG. TYI'W.-\ L A' D DISCH.-\RG' CL' RYES FOR P L' RI'US[ ( [ LLS
( L' p TO 55
a\ C. (o8 f. 1. DischJrc:e 6 hours after chars c.
(.\'1{( iJOII N::'.H
elcct rolyie is a soluti on ol caust ic o:- ::xtrcm::- purity, in distil led w:J. ter.
On duty. t here is no iimit to b:t ttery life that can be expected.
Yol tagc Characteristics
Ti:c \ ol t:tge of this type of fl:J.t pbte cell :11 til e commencement of normal ch:1rge
is about l-! \'Olt s. \lhi ch ri ses gradually during the fi rst ti\'O-thirds of charge to
about l --t_:; 1ol ts : then t here is 2. steep rise to about l 69 volts at the end of t he
charge. On discharge at t he 10 hour-r:J.te. t he init ial Yoltage is 1 3 finis hing at
i l 1 olrs. giving an a1erage fi gure of l .., Typical charge a nd discharge curws
are sho\\'n in Fig. 28.
Control and Chargi ng Gear
The conrrol a nd charging gear normally s:.;pplied with a system using alkaline
fiat plate cells fall s into three groups.
1.
3.
Equipment to .protect tf. e operati rg ti:eatre li ght fitting.
Equipment to supply general emergency lighting. anaestheti c rooms, etc.
Equipment to protect operating theatre fittings. and also to supply general
emergency lighting.
As the Yari ous 1ypes of operaung lighi fitt ings have al ready been
EMERGEl'.'CY SYSTDIS 53
described; it is not necessary to repeat in full their description here. The type
with a sin!!le li !!ht source and three auxiliarv !amos for emen:encv supply. is
now outdated, there are still in 'use in hospitals. Wi th this
type of fitting it is essenti al to protect against fibment breJkage. in addit ion to
the more usual failure of the mai ns supply, or fuses. This fitting wi ll need a
single-rate charging equipment with a series rel:iy. The coil of the rei ay is in
series with supply to the mai n lamp, hol"ding the relay cont:J.cts open. The
emergency lamps only light when current ce:.!ses to Aow through the mo.in
lamp (fig. 29). Although this ty;Je of fitting and emergency system is so.fe
enough. it is not altogether satisfo.ctory :::s the light field and inteilsiry \\i ll :llter
when there is o. changeover to eme;-g::xy op::r:J. tion.
There are very fe\\ligh t fittings use a cluster of lamp> o.nd a single reAector
instead of the comention:::I single iight source :::nd reAecror: or r;>ulti-reAc:: ror.
But should an engineer :::t a hos;Ji:al cie::ide to fix up J temporary light usit:g
this system. then the SJmc type of emergency s::heme will app!::. excent that a
\olto.ge re!Jy is used insrc:>.d of a current relay. the coil being conne:: ted
the mai ns supply. fi !Jmcnt failure under thes:: conditions is nor comidered J
risk requiring special attcmion o.s nor more ti;Jn one fibmenr is iikci: to fuse
at the sJme time. In bot h the foregoing types the m:.:in bmp. or ;Jre
at full mains YOitage. ti-.c emergency lamps \"aryir.g :1.cco;-ding to" is :t\'Ji!:tble
at the being usu:llly .:25 ,olts or 50 volts.
Where the light fitti ng a sir.gle light souice. hut with tile m:ti n l;:;mp
N El-f\TH
j_
+
FJG. OF OPERATJSG THEATRE E\!oRGESCY LiGHTJsG FOR UsE
\\"JTH A MAI'-:5 SI'-:GLE LIG:iT SOURCE A:-:D T HREE At:XILIARY L-\\IPS
Using a :\!inor Cont rol Unit.
\ !_ \ b
.\IE DICAL ELECTRICA L EQt.:Jn!E]';T
l MAlt-.$ N t: ..
'
' I

I s.;

S b I o
o;;
Fr c, .' 0 -CrRcTn o; .\l .,rsi ,\I SED E ' I ERGE,C\ OPER,\Ti'G THEATRE 'Lr GHTISG Usrsc
A '-r n -"r''ERf ., YLE .\l AJOR Co:--.-TROL U:--.-rT
I .

6 ' i '

+ - +

u.:..;a

9 s 7 b
STANOSY
'11
1
23
10> ill
10 5
9 8 7 6
CHA1-G:!.
STANOSY

l OA TIL
10 ,
9 0
6 7
OS:!'
FIG. 31. -CtRCLTI OF "OSMAI'-"TAISED GESERAL EMERGESCY LI GHTI SG US!:"G A NlFE
NE\'ERF."- YLE .t-.L>. JOR C osTROL ur-:tT
H!ERGE:t\ CY LIGHTI'-:G SYSTD!S
MAINS
I i
I I
tl
[Xl
00
...
s

I
+ UG"U -
I I I 1
8


, I 1
7 b ill 4!
1 " ez
6
6 .
s
5
s 5
0" .. O l'r (..uJ..:.I u.u ... tOtU.T
F IG. 32.-CIRCUIT OF 0 PERATII'G THEATRE A?' D GESEI\ AL
LIGHTJsG Us1sc NIFE NEVERFAYLE Co:-.-TROL tJ:>:JT
55
work ing at lower than mains voltage, a slightly different system is used: The
mai n lamp operates through a step-down transformer. and the emergency \ 'Oil-
age is arranged to be the same as the transformed voltage. Thus the l:lmp
is used both for mains and emergency supply, and the light field does not
change on mains failure. To give prote:.:tion against fila ment fa il ure. three
auxil iary lamps are incorpora!ed in the fining. but only come into use in t he
e\ent of a filament failure of the main lamp. The auxil iary lamps are controlled
by a series relay, the coil of which is in the m:1in lamp circuit.
The mu,lti-reflector unit is coming into general usage in place of the single-
refl ector type. The risk of total fila ment failure is negligible and as all t he lamps
a re on together, either on mains or on battery, the control gear is simple. It
includes a changeover contactor, step-down transformer when operated from
he standard mains, and a battery charging uni t (Fig. 30) .
To consider now hospital emergency lighting equipment generally, these
systems usually operate on the non-maintained principle in which the emergency
li ghts are normally off and are li t only in the event of mains fail ure. These
general emergency lights are cont rolled by an On/ Off contact or and the vol tage of
,;.e system depends on the load, 'and length of cable runs involved. For
convenience, and where possible, 25 volts or 50 volts is normally used (Fig. 31 ) .
.. It is possible to combine the scheme which. protects the operating theatre
ught fitting, and that which supplies the general emergency li ghting. to form one
composite equipment and a typical circuit diagram is shown in Fig. 32.
Period of Discharoe
""
There is no definite ruling in regard to the period for which the battery supply
56 MEDICAL ELECTRICAL EQt.:JPMENT
'
FJG. CLBICLF
FOI( :-.;r;-c-:-.;E\"ERF.\YLE \li'.OR E.'IER-
G'-'CY LIGHTI"G U:--:JT
Frc. luhrni').-:-.;Ew CO'.TROL
CL:BICLE FOR ?'IcE- YLE
M.\JOR r: \JERGE!SCY LrGHTil'G 0:-<iT
IS to light to tile opcr:ltlng theatre light fitting .. lt is generally
that ti1e baucries should be of such capacity to supply
emerger.cy p011er for the length of time that wouid be required for performing
an op:Tation. Hospital en!'ineers would be well ad1ised to consult the surgical
staff on this point. ?\ormally a period of three to four hours 11ould be seiected
as adequate, gi1ing a margin for contingencies.
]\ r aintenance
The maintenance of emergency lighting equipment using alkaline batteries
is extremely simple. All that is necessary in connection with the batleries. is
to gi1e them an occasional boost charge to compensate for intermittent dis-
charges 11 hen the com actor or relay is tested, and iO inspect the cells periodically
to ensure that the cell plates are coYered with electrolyte. As the specific
graYity of the cells does not vary on cf:arge or discharge, there is no need to
keep records of specific graYity of indiYidual cells. It is recommended that a
periodical test of the emergency circuits be made to ensure that all lighting
fittings operate satisfactorily and that the contacwr. and relays are working
properly. Alkaline batteries can be accommodated in any conYenient space in
the hospital, there being no need for the construction of a separate b:mery-
room as no obno\ious fumes are emitted by the cells. Figs.,33 and 34 illustrate
H!ERGE:-;CY SYSTEMS 57
self-contained units, with the batteries in the same corr.panment as the control
and charging gear. The unit shown in Fig. 34 is a larger unit for a 50-volts
system.
LEAD-ACID BATTERIES FOR EMERGENCY LIGHTING
Although the alkaline battery has found. favour with many engineers. there
is still much to be said for the acid-type battery, a:.d there are m2ny installations
throughout the world using a well-known battery of this type. Fig. 36 shows a
typical charging and control cubicle which incorporates lead-acid baLeries.
Construction of Lead-Acid Cell
Fig. 35 shows a typical battery suitable for hospital emergency use. This
type of cell is of the well-knmm Plante construction, in glass boxes with sealed
ebonite lids. As this type is better adapted than any other to trickle charge
operation, it lends itself to the constant use of hospital work_. The trickle
charge rate required is extremely low and the anticipated life on trickle ch:.1rge
is more than rwemy years at ful l rated capacity throughout. The se:lled lid
construction allows no spray to issue during charge. ::md reduces e\apora-
tion to almost negligible quantities, so that topping-up is requirc:d only about
rwice a year. To quote from the makers' specification: the container is annealed
moulded glass of great strength. and the interior of the cell is Jh\ays vi<.ible.
Glass feet, moulded on the underside of the container. give sufficient insul::!tion
for all but special high-voltage work which is outside the norm:1! requirements
of a hospital emergency lighting system.
The plates are suspended by lugs which fit into deep
sockets moulded in the glass box. gi,ing-a rigid assembl y.
These plates are separated by diaphragm separators.
which completely cover the face of each plate and project
beyond its edges, thus precluding the possibility of in-
ternal short circuits. The electrolyte does not need
renewing throu!:!hout the life of the olates. Cnli ke the
alkaline- they are not free from self-discharge.
but are perfectly satisfactory pro\iding a proper trickle
charge system is installed.
Control and Charging Gear
Fig. 36 shows the standard Keeoalite cbarin2: and
control cubicle and Fi2:. 37 a sn;:::lll control
suitable for the hospital, or nursing home.
Both types have a selenium rectifier. transformer. trickle
charger, ammeter, main, and fuses, and quick-
charge switches. Should the hospital ha,e a D.C.
mains supply rather than the more usual A.C.. the
selenium rectifier and transformer are omitted a
resistance substituted. '
E 6i,
FIG. 35.-THE CHLORIDE
LEAD-.-'.CiD SEALED-JC.:
CELL TYPE DBNG4
58
MEDICA L ELECTRICAL EQUIPMEXT
FJG. 36 (/c/1). - STA':-:DARD KEEPALITE
CHARGI':'G Aso Cos>ROL CUBICLE
( WITH COVER R.E.\10 \'ED)
FiG. 3/ (abme). - A.C. JUNIOR !-.: EEP-
AL!TE Ct:BICLE, MODEL No. 1 AJX
( WITH COVER RE\IOVED)
(Chloride Ltd.)
FJG. 38.- CtRCLIT OF LIGHTING SYSTDI FOR THE HOSPITAL OR
1'\L"RS!:'.'G HmiE
. Using a :"'o. I AJ or :! AJ Junior Keepalite equipment and switch relay with operating
tneatre
A. \ !.',in swi tch.
B. fuse.
C. Rectifier.
D. Ammeter.
E. \lilliammeter.
F. for trickle charge.
G. Quick charge swi tch.
H. Quick charge resistance.
J. Rectifier ou1put fuse.
K. Discharge fuse.
L Battery.
E.L. Emergency lamps.
M.L. :\iaio lamp.
M.S. :\lercury Switch.
R.C. Relay Coil.
D.P.S. Double-pole Swirch.
(Chioride Baueries, Lui.)
EMERGE NCY LIGHTING 'SYSTBIS
A . r-btn S-Itch
B. h:se
C. ContJICtOt
D.
r--" V E. Mll l)mfTICter
h. ' F. lor
N D G. Outc:.. Swncn
H . Vct:meu:r
J. Vol ;mner ) ,... ttCt>
1, 1
K . S..1:tc:ry
'l L. Ge-.1 eme-ren<r L1 nt>
r rr.A Rn .t uncc
= J E" 0 . J\. c: ctofocr CutPul
)T'
------- - - -- I '
t.l:... '
S-tch-Rehy
in No. I in Qperattnc Theave No. 2
H.L. MJon
E. L. Cmcr:cnC
M.S. Mcrcur,. S ... t: ch
R.C. hci.t., Cod
O. P.S. Double ro:c-
....
FIG. 39.-C!RCL:IT USE OF Two SwiTCHES
RELAYS 1a,. Two THEATRES WITH 0:-;E
CEr-;TRAL KEEPAL!TE EQt:!P.\!EKT
(Ch/orid< Boueri(S, Lid.)
59
Fig. 38 IZiYes the lavout of an emer!!encv sYstem suitable for the small hospital
or nursing-home. The control cubicle in Fi!!. 37 is designed for use with
this system. Fig. 39 shows useful emergency ;ystems for twin operating
theatres. Each of these systems acts automatically and indepsndently of the
Other. It should be noted that no matter which of the fuses blow, whether
main, sub-mc.in, distribution, or sub-distribution. the interruption of the normal
theatre light causes the emer!!encv ]amos to li!!ht: filament failure is also covered.
It should be remembered th;t b;th th;se are designed for the older type
60 \!EDJCAL ELECTRJCAL EQUJP\JEKT
of light fining which uses a single light source, plus auxil iary lights, but it can
easily be adapted to the modern niulti-refiector unit.
:\ Iaintenance
)\fainrenance of the batteries and control equipment of these systems 1s
comparati\ely simple: providing a few fundamental points are observed. In
the initial stages the equipment \\'ill be installed by the makers: or conrrac to:-s ,
and hand;:d over to the hospital engineers with the baneries charged, .::nd
with the correct kYe! of electrolyte in the cells. - The equipment will be con-
nc>cted to the lighting senice to be suppiied, and wili be left working corrccc iy.
Thereairer it is necessary for the engineer to ensure that the elec trolyte is kept
at tile correct le,el by the addit ion of d:srilled water as necess2.ry. t hough ti1i s
will not be a frequent operation under c. trickle ch3.rge system. Acid
ne,er'be added. c.nd the battery makers' advice shou:d be obtained when a fault
in a battery oc-curs.
The specific gra,ity of the electrolyte in all cells should be checked occasion:J iy
tQ ensure rh::n it is being maintained at tbe recommenced specific fiavity. \1 it'; in
approximately fi,e points. For example. if the recommended , alue is 12l(J it
should normal ly read between 1205 and 1-215. Th= gravity wi ll of course l:!ll
during emergency disch:!rge.
The should [1:; J.;c)t cleJn and free from concensJtion moisture.
eel!,;' tcrm;nals should oe periociic::J.lly and the connectio:1s checked ior
tightness. rile bolts Jnd termin:1ls b"eing smeared with pet roleum _i;:lly.
The should m::J.intJincd on co:ltiQuous tric:.el und ni; ht.
The quick of ch::.r_!:c need be switched on only after emergency discharges,
w tf:e batter' b:;ck to a full state of charr::e. but it is ad,is:;.ble to test t he
quid c-:-.:;rgc perio.cic:llly to make sure that all-is in order. :\ak::d flames. or
s;nrks re.g. lighted matches or ciga rettes) must ne,er be all owed ne:u tile
baneries.
ventii::tion of the battery-room should toe pro,ided by the eng:n-
eer. bui it is not essential for closed-top trickle charged batteries. of small or
medium size. to be housed in special battery-rooms. The automatic changeo,er
contacwrs. or mercury tube relays which are normal with this type of equip-
ment. should be tested regularly to ensure that they are operating correctly.
This can be effected by temporarily removing the c.ppropriate mains circuit
fuses or by switching off the appropriate mains supply. Detailed instructions for
indiYidual system.s are normally obtainable from the r:1akers of the equipment.
It should be remembered thc.t no matt er how gooc the equipment supplied
for the eo.;ergency system, some maintenance must be cJ.rried out. and the senior
engineer "ould be well advised tO detail a responsible person from the engineer-
ing staff w check the system at regular inrervals, r::.ther than to rely on the
thearre staff. lr is probably worse to haYe a battery system that fails in use,
than not to have or.e at all.