electrosurgery Flashcards
Assess the patient preoperatively for the presence of ?)
foreign bodies (eg, IED, jewelry, prosthetic implants
Place patient monitoring electrodes (eg, electrocardiogram, oximetry, fetal) as far as possible from the surgical site
Placing electrodes as far as possible from the surgical site decreases the risk for a burn at the electrode site.
When jewelry cannot be removed?
notify the surgeon,
consider using alternate technologies if jewelry is in the current pathway,25,49,50,52
provide education to the patient regarding potential adverse events and document the education provided,
assess all jewelry sites postoperatively for any evidence of burns, and
document preoperative and postoperative assessment of jewelry sites.
Follow the manufacturer’s written instructions for ?
use (IFU) for all ESU components.
Perform the following fire prevention interventions when using an electrosurgical device:
use technologies other than monopolar (eg, bipolar devices, coblation technology, non-energy-applying instruments) during surgical procedures on anatomical structures that present special fire hazards (eg, bowel, trachea)12,19,23,26,55-59;
use moist radiopaque sponges near the ignition source12-14,19,21,57,60,61;
remove alcohol-soaked sponges or other application devices from the sterile field14,18,22,62-65; and
allow alcohol-based solutions to dry and fumes to dissipate before using any type of electrosurgical active electrodes
Perform the following fire prevention interventions when using an electrocautery device:
use radiopaque sponges moistened with nonflammable liquid near the ignition source,67
apply the protective cap when the cautery is not in use,68 and
remove the wire loop and batteries from the electrocautery device before discarding it.
When patient or personnel injuries or equipment failures occur during the use of an electrosurgical generator or accessories,
remove the electrosurgical generator and accessories from service;
retain all accessories and packaging if possible69; and
report the adverse event details, including device identification and maintenance and service information, according to the health care organization’s policy and procedures.
Keep safety and warning alarms and activation indicators on the generator operational, audible, and visible at all times.
Safety and warning alarms alert the operator to potential equipment failure.
Select the what setting on the electrosurgical generator that achieves the desired result?
lowest power
Confirm the power settings on the electrosurgical generator with the operator before activation
If the operator repeatedly requests an increase in power, confirm the integrity of the entire circuit including the generator and all accessories
If the operator repeatedly requests an increase in power, confirm the integrity of the entire circuit including the generator and all accessories
Qualified personnel (eg, a biomedical engineering services representative) must perform periodic monitoring, inspection, testing, and maintenance on the electrosurgical generator.
Document inspection and maintenance according to the health care organization’s policy.
Document the following in the patient’s medical record in a manner consistent with the health care organization’s policies and procedures:
electrosurgical generator identification (eg, serial or biomedical number),
location of dispersive electrode placement, and
the patient’s skin condition before application and after removal of the dispersive electrode.94
Follow the electrosurgical generator and accessory manufacturers’ IFU when multiple ESUs are used simultaneously
Label accessories to correspond with the generator to which they are attached
Use one single-use dispersive electrode for each generator when multiple generators are used and
place the dispersive electrodes as close as possible to the surgical site,
do not overlap the dispersive electrodes, and
place the dispersive electrodes equidistant from the surgical site when it is a single site.39
