Module 10 Part 2 Flashcards
Electrical equipment in the OR must be _______ through a ______ wire
Grounded
Third
T/ F
There is no direct electrical connection between the power supplied by the utility company on the primary side and the power induced by the isolation transformer on the secondary side
True
T/F
A person in contact with only one of the two lines in an IPS system will receive a shock by completing the circuit
False, The person must be in contact with both lines 1 and 2 to complete the circuit. the ground is not part of the circuit
T/F
A faulty piece of equipment plugged into an isolated power system, may have a partial short circuit, but will not usually trip the circuit breaker
True
This type of device continuously monitors the integrity of an isolated power system
Line isolation monitor
A line isolation monitor measures the ______ to the ground on each side of the isolated power system
Impedance
Faulty equipment plugged into an IPS can change the system to a ______ system
Grounded
T/F 
If faulty equipment is plugged into the IPS it will continue to function normally but the LIM will alert that power is no longer ungrounded
True
What should you do if the line isolation monitor alarms?
Check the line isolation monitor reading and if possible unplug the last device that was plugged in
LIM Meter indicates how much current would flow in the event of a first fault and it’s set to alarm at _____
2-5 mA
In the event of a second fault with an isolated power system what can result?
Shock
What does GFCI stand for?
Ground fault circuit interrupter
How does a GFCI work?
It does not measure current but will trip and cut power when leakage current to ground exceeds a predetermined value in a grounded system-
Aka it monitors the difference in flow between two sides of the circuit and if a difference is detected the powers immediately interrupted
How do you prevent a second fault (the dangerous fault)?
Address the first fault by unplugging devices until you find the damaged equipment or issue that needs to be addressed
What does the first fault mean?
The first fault means that the line isolation monitor has detected that isolation from the ground has been degraded beyond a predetermined limit, a second fault may cause a shock
T/F
All electrical equipment should be tested periodically by trained personnel
True
If electrocautery is required, patient must have a properly placed ______
Dispersive pad
T/F
In the OR electrical equipment should be grounded (three pronged plug)
True
T/F
Do not use damage freight or crushed plug wires
True
T/F
If the LIM alarms immediately unplug the last electrical device
True
________ Involves relatively large amounts of current applied to the surface of the body. The current is conducted through all the tissues in proportion to their conductivity and area in a plane perpendicular to the current
Macro shock
T/F
Stray current from the electrosurgery unit can cause microshock
True
What factors cause a patient to be more susceptible/higher risk for microshock
CVP or PA catheter that is Saline filled
Pacing wires
Any direct external connection to the heart that may conduct a large current density directly to the myocardial tissue
Name the two types of ESU units
Monopolar and bipolar
How does an ESU work?
ESU operates by generating very high frequency currents (from 500,000 to 1,000,000 Hz) which passed through tissue. Heat is created by the resistance of tissue to current flow
Name two uses for The ESU device 
Therapeutic cut
Coagulation
How does a monopolar ESU safely direct energy?
Patient must have a properly place dispersive electrode of large surface area that returned the energy safely to the ESU device
If the dispersive pad for a monopolar ESU device is applied incorrectly, has damage wires, is broken, what can result?
High frequency current will seek an alternate pathway, such as ekg leads or temp probes, which have a lower surface area and can result in serious burns at these alternate sites or the ESU return site
Name three important factors for proper application of a dispersive return pad with ESU use
Ensure intact equipment- return wire instact and gel pad is not dried out
Place dispersive pad as close as possible to surgical site
EKG pads must be placed as far as possible from surgical site to avoid alternate route
T/F
Pools of flammable prep solution such as alcohol or acetone can ignite when the ESU is used
True
Name the precautions to be used when a monopolar ESU is used with a demand pace maker
The return electrode should be located below the thorax
Preparation for treating potential arrhythmia should be available- including a magnet to convert pacemaker to a fixed rate, a defibrillator, and an external pacemaker
It is best to keep the pacemaker out of the path between the surgical site and the dispersal plate
How is a bipolar ESU different than a monopolar ESU?
With a bipolar ESU the current passes between the two edges of the forceps rather than the forceps tip and the dispersive pad
T/F
Current in a bipolar ESU flows through only the tissue at the site of surgery and the return pad is not necessary
True
T/F
Bipolar ESU generates less power than monopolar ESU
True
Which ESU device is preferable in the presence of pacemakers, AICDs, deep brain stimulation, and spinal cord stimulation?
Bipolar ESU
T/F Healthcare facilities are required to have emergency power, typically electrical generators, the Sellitti is required to test every Three years for four continuous hours, ideally during peak usage of the system
True
T/F
Modern anesthesia machines do not depend on electrical power and function when electricity is lost
False
Modern anesthesia workstations are heavily dependent electrical power but do you have a battery backup system that can power the workstation for 1 to 2 hours
T/F
Without power only basic functions on an anesthesia workstation are available including emergency oxygen and conventional vaporizer to provide inhalational anesthesia
True
Which special vaporizer cannot deliver anesthetic without power
The Desflurane tech six and many newer electronic vaporizers cannot deliver anesthetic without electrical power
What are the steps to take in an emergency power failure when your anesthesia station no longer has power?
Convert to total IV anesthesia, use IV pump if batteries OK or administer IV and titrate to affect
Call for an extra O2 tank locate Ambu bag in case ventilator battery depleted
May be able to use transport monitor battery or may require manual BP and stethoscope

Maintain communication with surgeon that life-sustaining equipment is exhausted and surgery needs to end as soon as possible
What measures did ORs institute to prevent static electricity causing fires
Anti-static footwear
Nonconducting wheels on carts
OR humidity kept > 50%
Common term used in naming an ESU?
Bovie
