When using electrosurgery the doctor or nurse should minimize the risks of potential injuries to the patient. In order to accomplish this, the electrosurgical devices used, including bipolar active electrodes and vessel occluding devices, should be used correctly.
Bipolar technology uses an active electrode and return electrode in the form of a two-poled instrument like forceps or scissors. This is different than monopolar units, which only have one pole.
With bipolar units, the current flows only through the tissue contacted between the two poles. This makes the dispersive electrode unnecessary, and eliminates the possibility of current flows finding an alternative pathway.
The bipolar device also provides exact hemostasis or dissection at the surgical site with less potential stimulation or current spread to nearby body parts. For this procedure, molded, fixed-position pin placement bipolar cords should be used.
If you have both monopolar and bipolar devices, you should keep their cords stored separately so as to prevent any misconnections of active and return electrodes. If the cords get mixed up and a bipolar active electrode cord is connected to a monopolar device, a monopolar current may be activated and cause a patient injury.
There are also ultrasonic devices that can be used. These have a generator that produces ultrasonic energy and mechanical vibrations instead of the electrical energy that is typically used.
Ultrasonic devices cut and coagulate by using the mechanical energy and heat that is generated to change the natural properties of protein and the formation of a coagulum. A blade can be used for exact dissection, coagulation, or breaking apart tissue without damaging any surrounding tissues.
There are some ultrasonic dissectors that have an aspirator that removes tissue or fluids from the surgical field. When using this device, medical personnel should be aware that they do not need a dispersive electrode while the ultrasonic device is in use.
With such a device, no electrical current goes into the tissue so there is no need to have a return electrode because there is nothing to be returned. Be careful as to not inhale any of the aerosols that are generated by the ultrasonic hand piece.
In addition to aerosols, bio-aerosols are also a common thing produced by ultrasonic devices. This can be hazardous for both the patient and medical personnel.
Bio-aerosols have odorless, toxic gases, vapors, viruses, and dead and live cellular debris, such as blood fragments. With such threats, surrounding people are at risk for respiratory, ocular, dermatological, and other health related problems.
Patients or medical personnel run the risk of contracting mutagenic and carcinogenic symptoms. In order to prevent inhalation, some safety measures that can be incorporated include smoke evacuation systems and wall suction with an in-line ultra low penetration air filter.
Another risk to the safety of patients and personnel is Argon Enhanced Coagulation technology, also known as AEC. Each type of AEC has detailed written operating instructions that come with the unit.
In order to create the safest environment, these instructions should be followed. All safety measures for monopolar electrosurgery should be used when using the technology.
The Argon Enhanced Coagulation unit uses ionized argon gas to deliver a monopolar alternating current to the tissue. Because of this method, there are still risks from monopolar electrosurgery.
The system should be activated to clean the air from the argon gas line and electrode. This cleaning should take place before use, after any moderate delays during use, and between uses.
This will help prevent any delays in coagulation and will minimize the risk of gas embolism. When operating in an open cavity, failing to clean the argon gas line could increase your risks of blocking a blood vessel.
The flow of the argon gas should be limited to the lowest level possible, while still ensuring that it will provide the desired clinical effect. When the initiation of ionization of the argon gas is delayed due to air bubbles in the line, the flow will most likely be directed at the tissue without simultaneous coagulation.
Author Resource:-
Tommy Greene has worked in surgical equipment sales for the past 15 years. He has great advice and information on an Electrosurgery Generator.
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