PHYSICS

Electricity and magnetism Learning objectives

Jennifer Roe After reading this article, you should be able to:
C describe what electricity is and key components of electrical
Steve Roberts
circuits
C explain principles of common electric components

C describe the relationship between electricity and magnetism

Abstract
C give examples of applications of electric circuits and magnetic
This article introduces the key concepts of electricity, electrical circuits
and their practical applications to anaesthesia and patient safety. The principles relevant to anaesthesia
principles of mass spectrometry and magnetic resonance imaging are
also discussed.
Keywords Electric circuits; electric components; electricity;
magnetism law of electromagnetic induction. A straight current carrying
wire will produce a magnetic field proportional to the magnitude
Royal College of Anaesthetists CPD Skills Framework: Scientific principles and direction of current. A solenoid is created by coiling this
current carrying wire and therefore increasing the density of the
magnetic field. An electromagnet is a solenoid wrapped around a
ferromagnetic core. A direct current (DC) passed through a so-
lenoid will magnetize a ferromagnetic core, and conversely an
Electricity alternating current (AC) will demagnetize the core.
Electricity includes a variety of phenomena resulting from the Electromagnetic induction describes the voltage created
flow or presence of an electric charge. Anaesthetic equipment is across a conductor by a changing magnetic field (from moving
powered by electricity. Understanding the basic principles magnetic field or AC). Faraday’s law states that the magnitude of
involved help to mitigate and minimize electrical hazards. voltage created is proportional to the rate of change of the
magnetic field or the frequency of AC.
Electric charge and current
Fundamentally, atoms consist of positively charged protons and Ohm’s law
neutrally charged neutrons within the nucleus. Negatively This determines the relationship between current and potential
charged electrons orbit the nucleus and under certain conditions difference. It states that at a steady temperature:
can move between the outer orbits of different atoms, leaving Potential difference (V) across a conductor ¼ current (I) through
some atoms with an excess of electrons and some with a deficit. the conductor  resistance (R) of the conductor or V ¼ I  R.
Static electricity refers to an imbalance of charge on two dis-
similar materials, sometimes separated by an insulator. Static Voltage or potential difference (V) is the electrical force which
electricity exists until a path can be found to equalize the dif- drives the current. One volt is the potential difference between
ference in charge. Medical equipment with insulators can two points on a conducting wire carrying one ampere of current
develop a static charge on their surface, resulting in sparks which between which one watt of power (as heat) is dissipated. Po-
may potentially lead to explosion. tential difference (V) ¼ power (W)/current (A)
Electricity can flow as a constant current when a potential
difference exists between atoms and has observable effects such Current (I): the flow of current is measured by the SI unit of
as heating and magnetism. Heat is generated due to the first law ampere (A). One ampere flowing for one second passes a cou-
of thermodynamics (conservation of energy). This can lead to loumb of charge. Coulomb (C) is the SI unit for charge, a mea-
equipment overheating and potentially causing fires. Fuses are sure of the amount of electricity. One coulomb contains 6.24 x
metal wires designed to melt when overheated by an electrical 1018 electrons. One ampere flowing for one second passes a
current, therefore preventing the circuits from overload. coulomb of charge, so current (I) ¼ C/second.
Electricity and magnetism
Resistance is a measure of the opposition to flow of current and
A wire carrying an electric current induces a magnetic field
is measured with the SI unit Ohms (U). One ohm is the resistance
around it which can be used to provide mechanical force as in an
that will allow one ampere of current to flow when one volt of
electric motor. A changing magnetic field along a wire induces a
potential difference is applied. The resistance depends on the
current down it, as seen in a generator or power station. Max-
material and shape of a substance. A long, thin wire has higher
well’s equations mathematically explain how electric currents
resistance than a short, thick wire.
create electric and magnetic fields and is derived from Faraday’s

Conductors, semi-conductors, and insulators

Jennifer Roe MBBS FRCA is an ST6 in Anaesthesia in the North West In electronics, solids can be classified into conductors, semi-
Deanery, UK. Conflict of interest: none declared. conductors, or insulators. Conductors have loosely bound elec-
Steve Roberts MBChB FRCA is a Consultant Anaesthetist at Alder Hey trons in their outer shell, which move easily under the influence
Hospital, Liverpool, UK. Conflict of interest: none declared. of an electric potential. Most metals are conductors, also carbon

ANAESTHESIA AND INTENSIVE CARE MEDICINE 24:4 251 Ó 2022 Published by Elsevier Ltd.
 PHYSICS

and ion-containing solutions such as saline. Insulators have Resistive elements: resistance, measured in Ohms (U), remains
firmly bound electrons which do not allow current to flow. Ex- constant in a circuit. Impedance is a measure of how much a
amples include glass, rubber and mica. Semi-conductors are in- circuit impedes the flow of current in a circuit and is a consid-
termediate materials whose electrons can be induced to move if eration of how capacitance and inductance affect flow of current
given more energy, for example changing temperature. Therm- in a circuit. Accordingly, impedance varies with frequency.
istors, transistors and diodes consisting of selenium, alone or
with lead, are examples of semi-conductors. Capactitors: a capacitor consists of two conductors (metal
plates) separated by an insulator (dielectric). The capacitance
Alternating current and direct current of a component remains constant, as the potential difference
Electric current can flow in two ways in a circuit. DC is when the across a capacitor plate is proportional to that of the battery
current (or voltage) is a constant level in one direction, as seen voltage. When DC current is applied, a capacitor stops the flow
with batteries. AC has flow in one then the opposite direction in a of current, as the voltage is constant. When an AC current is
sinusoidal wave. This is the seen in mains electricity, which applied to a capacitor, the voltage never reaches steady state
switches from positive to negative pattern 50 times per second conditions as with DC, so the current continues to flow. If the
(50 Hz frequency). The AC wave is quantified using root mean frequency of sinusoidal AC wave increases, the current flow
square (RMS) of the waveform. RMS is calculated by squaring the also increases. The resistance to flow is inversely proportional
waveform which converts any negative values to positive values. to the frequency and is called reactance. Capacitance can exist
The mean is calculated and the square root taken, giving mains UK between any two conducting bodies, for example a patient and
current as 230 RMS. Higher frequencies do not transmit an electrical cable, and is a can be a source of interference in
economically over long distances. Unfortunately lower fre- the ECG.
quencies such as 230 RMS carry a higher risk of excitation of
muscles and nerves, increasing danger from electrical shocks. Inductors: an inductor is a wire coil of conducting material
wrapped around a core of magnetic material. Changes in the
Electric circuits and components current passing through the coil changes the strength of the
Electric circuits consist of a power source and electrical loads. magnetic field inducing an electromagnetic force (voltage) in the
The common components of electric circuits can be seen in coil. When DC current is applied, the magnetic force produces
Figure 1. In a series circuit, all components are placed end to end, voltage of opposite polarity to the driving voltage, opposing the
forming a single path for the current to flow through. In parallel current flow. This is used to create a Lown waveform (heavily
circuits, electric loads are placed in parallel to each other, and damped sinusoidal waveform) to minimize the peak current, as
have the same voltage across each of them. This principle en- high peak currents are associated with myocardial injury.
ables the production of Wheatstone bridges, essential to accurate
measurement required in medicine. Transformers: a transformer consists of primary and secondary
There are four classes of electrical component: coils of conducting material wrapped around a single ferromag-
1. Resistive elements: dissipate energy netic core, and transfers energy from one circuit to another due
2. Capacitors: store energy in an electric field to the principle of electromagnetic inductance. The primary coil
3. Inductors: store energy in a magnetic field is connected to AC and induces electromagnetic force (EMF or
4. Transformers: adjust levels of voltage and current. voltage) in the secondary coil. In a step-down transformer, the
secondary coil has fewer windings than the primary coil resulting
in a smaller EMF than the initial EMF.
Common electrical components and their An isolation transformer enhances the isolation between
symbols primary and secondary coils and forms an important part of
floating circuits (providing that the secondary coil is not
Power source Resistor earthed). Class III electrical equipment contains a floating circuit
and aims to minimize stray leakage current that can cause
Earth Variable electrical injury.
resistor
Defibrillator
Capacitor Fuse This essential piece of resuscitation equipment utilizes many of
the electrical components described above. The circuit for this
Inductor Switch can be seen in Figure 2. A defibrillator consists of two circuits
connected by a switch. The first (charging) circuit has a step-up
transformer to increase the voltage from 240 V to 6000 V, a
AC power Transformer rectifier which converts the AC to DC allowing the capacitor to be
source
charged. The second (patient) circuit has an inductor, two elec-
trodes connected to the patient and another switch to deliver the
stored charge to the patient. The inductor delivers the current in
Galvanometer
the Lown waveform, causing a synchronous contraction of the
cardiac myocytes. After the refractory period, it is hoped that the
Figure 1 normal heart rhythm resumes.

ANAESTHESIA AND INTENSIVE CARE MEDICINE 24:4 252 Ó 2022 Published by Elsevier Ltd.
 PHYSICS

Defibrillator circuit
Charging circuit Patient circuit

Patient
Capacitor

Step-up
transformer
Inductor

Figure 2 Defibrillator circuit: when the charge button is pressed, the capacitor is charged. To deliver the shock, the patient circuit is completed,
allowing the capacitor to deliver its charge.

Magnetism field due to an unpaired electron in the outer shell. This is the basis
of paramagnetic oxygen analysers, as most molecules are
Magnetism results from the motion of electrically charged parti-
diamagnetic (repelled from magnetic field). In mass spectrometry,
cles, one aspect of electromagnetic force. Magnetic fields are a
gas molecules are ionized and passed through a magnetic field to
vector fields, they have a direction as well as strength. As topo-
separate them according to their molecular mass.
graphic lines close together represent a steep gradient on a map,
denser magnetic fields represent a stronger magnetic force. The SI
Magnetic resonance imaging (MRI)
unit for magnetic flux is the Weber (W), magnetic flux density is
Magnetic resonance (MR) scanners have become more prevalent
measured in Tesla. One Tesla (T) is one Weber per metre squared.
since the 1980s. Some patients require anaesthesia for imaging
Magnetic materials alone, others as part of a complex operative process. MR scans
Magnets produce magnetic fields which attract or repel other ob- are performed without the use of ionizing radiation and provide
jects. Most strongly attracted materials have unpaired electrons in more information on soft tissues than with CT. MRI is not useful
their outer shell, such as iron, cobalt, nickel and their alloys. for bone as the protons are fixed within the tissues.
These are called ferromagnetic materials and can form permanent Hydrogen atoms (protons) are abundant throughout the body,
magnets once magnetized. Paramagnetic materials include plat- in many molecules including water. Precession of protons (spin-
inum, oxygen, and nitric oxide, and are attracted into a magnetic ning on the atoms own axis) within magnetic fields enable MR

Cross-section of MRI scanner

Liquid helium

Primary electromagnetic coil

Magnetic gradient coils

Radiofrequency transmitting coil

RF receiving coil

Scanner table

Figure 3

ANAESTHESIA AND INTENSIVE CARE MEDICINE 24:4 253 Ó 2022 Published by Elsevier Ltd.
 PHYSICS

images to be formed. When a large magnetic field is applied to a the extremely powerful magnets used for MRI, and the tech-
material (1e3 Tesla), atoms align themselves. Most are parallel (in niques used to enable the magnetic fields to be produced, there
the same direction as the magnetic field), but a small number are are numerous safety issues to be aware of. The Association of
anti-parallel (opposite direction to the magnetic field) which is Anaesthetists publication ‘Guidelines for the safe provision of
associated with a higher level of energy, therefore are more un- anaesthesia in magnetic resonance units 2019’ contains advice
stable. For each atom the Lamor frequency represents the fre- regarding best practice. A
quency of precession and the strength of the magnetic field. These
signals from precession are too small to be detected easily. How- FURTHER READING
ever, if another magnetic field is applied perpendicular to the first Armstrong F, Teo W. Electricity and magnetism. Anaes and Intensive
magnetic field, with a frequency aligned to the Lamor frequency, Care Med 2020; 21(5): 252e5.
nuclear magnetic resonance is said to occur. The perpendicular Magee P, Tooley M. The physics, clinical measurement and equipment
field causes the atoms to align in an anti-parallel orientation, which of anaesthetic practice 2nd edn. Oxford: OUP Oxford, 2005.
then gives a higher energy signal which can be detected by the Magee P. Physics for anaesthesia. BJA Education 2018; 18(4): 102e8.
radiofrequency receiver when the atoms precess. Different tissues Singh S, Ingham R, Golding J. Basics of electricity for anaesthetists.
have characteristic precession times, which enables images to be CEACCP 2011; 11(6): 224e8.
reconstructed. The organization of magnets can be seen in Figure 3. Wilson S, Wilson SR, Shinde S, et al. Guidelines for the safe provision
In T1 images, the atoms are realigning to the low-energy di- of anaesthesia in magnetic resonance units 2019: Guidelines from
rection giving energy to the atomic lattice. In T2 images, atoms the Association of Anaesthetists and the Neuro Anaesthesia and
give spin energy to neighbouring atoms. T1 images make fat Critical Care Society of Great Britain and Ireland. Anaesthesia 2019;
appear bright, and T2 images make water appear bright. Due to 74: 638e50.

ANAESTHESIA AND INTENSIVE CARE MEDICINE 24:4 254 Ó 2022 Published by Elsevier Ltd.