Electrosurgical Safety
ESU stands for
What does Electrosurgical Unit?
Name the person responsible for documenting during tourniquet use
Who is the circulator? Who is the anesthesia provider?
What is an Implanted Electronic Device?
Name the 3 tenets of radiation safety.
What is Time, Distance, Shielding?
Mine three elements of the fire triangle
Ignition source, fuel, oxidizer
What does IFU stand for?
Instructions for Use
Name one ESU electrode? ?
Monopolar, Bipolar, Argon beam, Vessel sealing, Tripolar
LOP stands for
What is Limb Occlusion Pressure?
Precautions are needed for implanted devices. Name one type of device.
Pacemaker, defibrillator, cochlear implant, deep brain stimulator, vagal stimulator, spinal cord stimulator, gastric pacemaker
Name the PPE required for Radiation Safety.
Lead apron, thyroid shield, leaded eyewear if possible
Name an example of an ignition source
Where do we find IFUs
Sterile processing, biomedical engineering, surgical services, or online, company website
This is where the return electrode should be placed.
Well vascularized muscle tissue close to incision, avoiding bony areas, scars, tattoos, implants
Name 2 contraindications for tourniquet use.
DVT, revascularization,
age ≥60,
BMI ≥30,
diabetes,
impaired skin integrity,
trauma,
lymphedema,
PVD
What should be placed as close to the surgical site but far away from the generator & leads.
What are Pacemaker, defibrillator, cochlear implant, deep brain stimulator, vagal stimulator, spinal cord stimulator, gastric pacemaker
Laser warning signs are utilized when laser in use. Name the locations.
Outside of the OR/Procedural Room, Cover windows
Name one example of a fuel source
Drapes, alcohol-based skin prep, etc.....
Things that occur when IFUs are not followed
Patient injury, voided warranty, accreditation citations
Name two causes of electro surgical burns.
Insulation failure, antenna coupling, direct application, direct coupling, capacitive coupling, residual heat, inadvertent activation, EMI
Elevation, elastic wrap, or Webril
Cords should be placed away from the pulse generator to prevent this
What is interference or current pathway crossing the device?
Laser Key should be kept when not in use.
Secured locations dictated by Director of the unit.
When should you do the Fire Risk Assessment?
PreBrief (optional) and Time Out (mandatory)
Name three items to document about tourniquet use
Assessment, cuff size/location, who applied, skin protection, inflation/deflation times, pressures, reactions
Name the difference between monopolar and bipolar energy.
What is a return electrode for Monopolar; What is using both electrodes at the instrument tip for Bipolar?
Name ideal time for tourniquet inflation time.
What is ,As short as possible, typically less than 2 hours, with reperfusion intervals if longer?
Precautions taken with cochlear implants during surgery.
What is remove external components, avoid electrosurgery within 2–3 cm of generator/electrodes?
Name the requirement for Laser Safety prior to using the laser.
A Laser Time-Out and testing per IFU
State the steps to do if a drape catches fire
Stop gas flow, remove drapes, extinguish fire, assess patient
Skin condition, circulation, motor/sensory response, vital signs, ischemia/reperfusion response are elements documented when about tourniquet use?
Post procedure
Name the definition of thermal spread
What is the unintended extension of heat damage to surrounding tissue?
Name two signs of nerve injury or compartment syndrome after use of tourniquet.
Pain, numbness, paresthesia, decreased motor function, sensory loss, swelling
The area of focus for IEDs postoperatively we should focus on with handoff.
What is consultation with device managing team, patient/caregiver education regarding device?
Name examples of Hierarchy of Controls
Elimination, Substitution, Engineering, Administrative, PPE
Ensure fire safety equipment available, monitor for hazards, coordinate response
Documentation is critical for accreditation for what reason?
Provides evidence of compliance with safety standards and policies