Patients should be placed in their final position for surgery before the single-use dispersive electrode is placed on the skin of the individual. Attempting to move the individual after the adhesive has been applied to the skin may disrupt the electrical flow.
This may cause such problems as tenting, gapping, or moisture collection. Any of these occurrences that have to do with improper contact to the skin have been known to cause injury.
If any tension is applied to the cord while trying to move the patient, the attending nurse should do a reassessment of the integrity of the dispersive electrode. They should also evaluate the contact with the skin of the individual and the connection to the electrosurgical unit.
Moving or repositioning the individual could lead to the adhesive coming out of contact with the skin of the patient. Because of this possibility, the nurse should ensure that the dispersive electrode has remained in full contact with the skin of the patient.
Failure to do this and having the contact be broken could result in burning the skin or tissue of the patient at the point of contact. Any warming devices that are present should not be placed near the single-use dispersive electrode.
The heat that emanates from the warming device combined with the heat of the dispersive electrode could have an impact on the formation of skin lesions. These should always be kept dry and away from fluids that may seep or create a pool under the pad.
Any liquids may prevent the pad from properly making contact with the individual. It may also cause injury or burns to the skin from long periods of exposure and the concentration of an electric current.
Any type of contact between the patient and metal device should be avoided during the course of the electrosurgical procedure. This may include the frame of the hospital bed, stirrups, positioning devices, or safety strap buckles.
Any of these could serve as an alternative return path for the electrical current to travel. Any metal jewelry that the individual may be wearing should also be removed before the procedure.
Jewelry on the hand, like a wedding ring, has the ability to cause swelling during the surgical procedure or during the recovery time period. Patient monitoring electrodes should also be positioned at a distance from the actual surgical site.
These monitoring devices include an electrocardiogram, oximetry, and fetal. Needle electrodes that are used for monitoring or other non-surgical functions should be avoided.
Needle probes should be avoided because stray current has the potential to flow through the needle and cause an alternative pathway to form. This may result in patient burns due to the potential for high current densities.
If the use of the needle cannot be avoided, medical personnel should employ the use of alternate electrosurgical technologies such as bipolar and laser. When more than one electrosurgical unit is being used simultaneously in one operating room for the same procedure, personnel should ensure the compatibility of the equipment.
They should also ensure that the equipment is functioning properly and corresponding to the monitoring systems. All of this should be checked with the manufacturer's instructions.
Personnel should make sure that they separate single-use dispersive electrodes for each electrosurgical unit. The dispersive electrodes should be placed in close proximity to the surgical site.
The dispersive electrodes should not, at any time, overlap. There are also many considerations that should be included during the process regarding high-current, long-activation time, radio-frequency ablations, and other procedures.
Such considerations include taking an inventory of the radio-frequency generators that will require special or multiple electrodes. Nurses should make sure that the adhesive is properly placed on the skin of the individual.
Non-conductive solutions are usually recommended for irrigation or distention purposes. The manufacturer's instructions for the equipment should always be followed to ensure the safest environment for the personnel and the patient.
Author Resource:-
Tommy Greene has worked in surgical equipment sales for the past 15 years. He has great advice and information on Diathermy units.
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