Electrosurgical safety Flashcards
Types pf current
- Monopolar
o Current through electrode to tissue then via patient to diathermy pad where the energy is dispersed over a large area to avoid burns
o Cut setting - Low voltage current with high density
- Low thermal spread
o Coagulation setting - High voltage current with low density
- High thermal spread
- Bipolar
o Current passes between two electrodes via the tissue
Electrosurgical complications at laparotomy
o Unintended activation of active electrode on other tissue
o Current diversion
-Electrical energy will find path of least resistance
- Modern systems will alarm if current not returned via return electrode
o Return electrode
- Poorly applied or partially detached electrodes may cause burns as energy dispersed over smaller area
- Modern systems have split-plate technology to reduce this risk
Electrosurgical complications at laparoscopy
o Direct coupling
- Current conducted through two non-insulated instruments that are in contact or non-insulated instrument and metal port
o Capacitive coupling
- Transfer of a current through an insulating medium
- Ie monopolar scissors in metal port (separated by monopolar scissors insulation)
o Thermal injury
o Insulation failure