basics about electrosurgery...electrosurgery – what is it? application of a high-frequency...
TRANSCRIPT
Acknowledgements S Minta, Ghana S Bäuerle, CH
Basics about electrosurgery
Date AOA Course–Basic Principles of Fracture Management for ORP
Name Country
Learning outcomes
Define electrosurgery List basic components
distinguish mono-and bipolar technique Train all staff in safety features for patients
in checking of equipment in mode of application
Electrosurgery – What is it?
Application of a high-frequency electric current to biological tissues in surgery
to coagulate blood vessels to cut tissues to destroy abnormal growth
of tissues (to fulgurate)
Electrosurgery unit
Basic components
1. Electrosurgical generator 2. Handpiece with cable 3. Neutral plate (electrode) 4. Foot pedal
Electrosurgery unit
Avoid electro-thermal injuries locally in surgical site
peripheral
Use safety features: lights, sounds
‼ Safety features were turned off…
Burn injury happened accidentally Handpiece was activated
‼ Safety features were turned off…
Handpiece
Monopolar handpiece different inserts
• knife, needle type (sharp) • ball type (blunt)
Bipolar forceps variations of forceps
2. It does not matter
3.Yellow button/pedal is used for coagulation
1. Blue button/pedal is used for coagulation
Usage of handpiece or foot pedal
2. It does not matter
3.Yellow button/pedal is used for coagulation
1. Blue button/pedal is used for coagulation
Usage of handpiece or foot pedal
What means monopolar technique?
Current flows in a closed loop
neutral electrode needed
from active electrode (in patients wound)
through patient to neutral plate (eg: placed on femur)
back to electrosurgical generator • active electrode in wound
What means bipolar technique?
Current flows in defined area and back
no neutral electrode needed
from one pole of forceps to other pole not through entire body
When to use bipolar technique?
For coagulation of vessels only hand surgery eye surgery
Patient with pacemaker
Neutral plate (electrode)
Where to place it? Types
reusable electrodes disposable electrodes
placed on dry, clean skin as close to operative site
as possible no contact with disinfectant
Neutral plate (electrode)
Where to place it?
Upper thigh Femur Buttocks Upper arm Back Abdomen
Don'ts for plate placement
Not on bony prominences Not on hairy surfaces
remove hair Not on scar tissues Not above hip prosthesis
What do you identify here??
Damage
on plate on handpiece on cable
Safety checklist for all staff members Inform yourself about
patients health status planned procedure
Choose best application site for neutral plate Check all basic components
1. Generator • how to set it properly for application
2. Handpiece 3. Neutral plate with cable
• check condition
4. Foot pedal • check function
2. Bipolar technique
3.Any technique would be too dangerous
1. Monopolar technique
Which technique must be used for patients with pacemaker?
2. Bipolar technique
3.Any technique would be too dangerous
1. Monopolar technique
Which technique must be used for patients with pacemaker?
Summary
Define electrosurgery List basic components
distinguish mono-and bipolar technique Train all staff in safety features for patients
in checking of equipment in mode of application