surgical energy Flashcards
ideal cases to use bipolar mode
- coagulating around nerves/brain tissues
- IED implanted electronic devices (pacemakers, mechanical implants like bone growth stimulator, cochlear implants, pain pumps), neurostimulators
capacitive coupling
- when current went from an intact insulated active electrode to adjacent but nonintentional conducive item
- common in laparoscopic electrosx
Safe Medical Devices Act of 1990
-all pt and personnel injuries from electrosx must be reported
what is the primary means of plume removal
LEV-local exhaust ventilation (smoke evacuator or wall suction w/ inline filter)
guideline in the usage of capture device in plume removal
-as close as possible but not >2 in from smoke source
secondary means of plume protection
- high filtration face/surgical masks
- N95
guidelines in dec gas emboli in AEC
- lowest gas flow setting
- air purged from gas line before use and during periods of unuse
- simultaneous coagulation of vessel so argon gas can’t enter
- intra abdominal cavity flushed w/ several liters of CO2 bt deactivation
- use lap insufflators w/ audible and visual over-pressurization alarms that cannot bee deactivated
which is more common: bipolar or monopolar
mono
flammable agents to ESU
ETOH based stuff, tincture based fluids, defatting agents, collodion
where to plug active electrode
stress resistant receptacle
capacitive-coupled return electrode
- a type of dispersive electrode pad that is full mat under pt
- no positioning device b/t mat and pt
how to reduce capacitive coupling in lap procedures
conducive trocar cannula instead of combination aka hybrid system like plastic and metal
w/ capture wand in plume removal, what are 2 reasons If still smell smoke but don’t see it
- Not enuf suctioning from wand
- Filter needs replacement
smoke evacuator LEV
- HEPA or ULPA filter
- need frequent flushing to reduce waste buildup
central suction system LEV
ULPA filter only bc only for minimal smoke
