To remove any debris from the active electrode tip before or after the procedure is performed, one should use a moist sponge to clean the non-stick coated electrode tip. Personnel can also use abrasive electrode cleaning pads to remove eschar from non-coated electrodes.
The tip should never be cleaned with a scalpel blade as this can put an individual at risk for a percutaneous injury. If the electrode becomes contaminated in any way it should be disconnected from the unit and be replaced.
Placing the active electrode in a holster will minimize the risk of accidental activation of the unit, which can cause injury to patients or medical personnel. If the instrument is being used in a wet or liquid-filled area, personnel should ensure that the fluid is electrically inactive.
The electrode may be less effective in practice if an electrolyte solution is used as opposed to a non-conductive alternative. Measures to ensure fire safety should be employed to foster an environment of safe medical practices.
Active electrodes should not be activated when near flammable agents such as petroleum-based lubricants and antimicrobial skin prep. Since these materials are commonly in surgical areas, a physician should wait until the materials are dry or liquids have evaporated before activating the unit.
Keep in mind that alcohol-based materials are flammable until they are completely dry. Vapors that take time to evaporate are also still flammable until completely dissipated.
When combustible gases are present in the operating room, caution should be used; especially around the head and neck. If the hand-held cautery being used is battery-powered, the batteries should be removed before disposal.
If the unit is unintentionally activated after disposal, it has the ability to start fires. Electrosurgical procedures should not be employed in an oxygen-enriched environment either.
Areas that are oxygen-enriched have a lower temperature and energy level, which makes it easier for fuels to ignite. The lowest amount of oxygen necessary to keep the patient healthy should be used when an active electrode is present.
Combining oxygen and nonflammable gases reduces the risk of fire in the surgical room. There should be a good amount of air circulation in the room to minimize the concentration of oxygen.
A fire extinguisher should always be readily accessible near electrosurgery equipment to stop fires. A small electrical flame could spread rapidly and cause damage to equipment, patients, and personnel if not put out quickly.
Other fire extinguishing materials that should be readily available include a wet towel, sterile saline, and water. If the flame is near the patient or in a compact environment, these materials will be most safe to use.
Burns to the skin tissue of the patient are the most common injury when electrosurgery is being performed. The condition of the patient's skin should be evaluated and documented before any procedures are performed.
Medical personnel should assess and document the condition of the skin prior to the procedure and after it is completed. This will help identify any lesions that occur during the procedure.
Dual foil return electrodes should be used when using contact quality monitoring.
If the resistance between the two foil plates is too high because of poor contact, an alarm goes off and the unit will stop functioning. If return electrode monitoring is not available on the machine personnel should be continually monitoring it personally.
A disposable dispersive electrode may be used for one procedure and should then be thrown away. If the tool must be repositioned during surgery, a new electrode should be inserted onto the device for the remainder of the procedure.
A better alternative is a large reusable, capacitive pad. This technology does not rely on an electronic interrogation circuit within the electrosurgical generator. The physics behind the capacitive pad limits current densities to maintain patient safety.
Author Resource:-
Tommy Greene has worked in surgical equipment sales for the past 15 years. He has great advice and information on Electrosurgery Equipment.
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