Electrosurgical units are one of the most common pieces of electrical equipment in an operating room. Although injury from inadvertent energy transfer isn’t frequent, it does happen, so it’s important to review safety measures and take the extra precautions to protect both your staff and your patients.
While preparing your office or OR for electrosurgical devices, follow these nine safety precautions.
1.) Know how to use the equipment. Safe use of electrosurgery equipment is most dependent on the knowledge and carefulness of the operator and assistants. Be sure that physicians have been fully trained and are comfortable with using the equipment. Ensure that all staff in the operating room have been trained and are familiar with the medical literature and specific precautions for the equipment as found in the manual.
2.) Install a smoke evacuation system. The smoke produced by electrosurgical procedures is unavoidable, but keeping the area protected from the harmful gases is not. A smoke eliminator in the operating room is necessary to greatly reduce the harmful side effects caused by breathing, or otherwise having physical contact with the surgical smoke plumes.
3. ) Use equipment and accessories as they were designed to be used. Simply following the instructions and precautions provided with all equipment will greatly reduce the possibility of injury. Use generators at the lowest setting recommended for the procedure and never substitute accessories and use them in any other method than for what they were intended.
4.) Test equipment before using on the patient. All equipment should have regular maintenance checks and tests to ensure they are working properly. Never use equipment on a patient until proper safety tests have been performed, any necessary adjustments have been made, and the piece has been re-tested.
5.) Do not use around flammable substances. Electrical current can spark almost any flammable substance, and many common flammables might be present in the facility – just be sure that none are near the operating room and equipment. Examples include flammable anesthetics, alcohol based skin prepping agents, and oxygen enriched atmospheres. Follow fire safety precautions.
6.) Avoid use around external or internal electrical devices. Use extreme caution when in the presence of devices such as pacemakers or pulse generators. Interference for these devices caused by electrosurgical equipment can cause malfunction. Consult a cardiology department for advice when operating on such a patient.
7.) Avoid contact with metal. Electrosurgical burns are more likely if the patient or physician comes in contact with a grounded metal object during the procedure. Remove loose fitting jewelry and examine the equipment and accessories to ensure there are no exposed metal parts.
8.) Avoid skin to skin contact points. Alternate site burns can occur when skin inadvertently comes between the route from the surgical site to the return electrode. Position the patient to ensure a direct return electrode route. Bovie Medical generators come with a contact quality monitoring system which can help avoid this problem.
9.) Be mindful while using the equipment. Injury burns to both patient and staff can occur through carelessness during a procedure. Always place the electrode tip in its insulated container while on the surgical field. Ensure the patient does not come in contact with metal or other conducive materials. A shock can occur if the surgeon holds the instrument too close to the tissue.
Proper training and common sense can work together to prevent injuries during electrosurgery. To make sure that you are being as safe as possible, use equipment and accessories as intended, follow product safety guides, and most importantly ensure you have a well trained and knowledgeable staff.