电外科的安全.ppt

感谢聆听 THE END * Why do surgical team members sometimes get shocked while holding a hemostat? A hole in their glove, frequently blamed for this occurrence, is actually a result of the shock. The current applied to the hemostat that is clamped to the bleeding vessel will travel to the tissue, seeking the return electrode and thus attempting to complete the circuit. As the tissue is desiccated, the resistance rises. When the resistance reaches a point where the path of least resistance becomes the person holding the hemostat, the current will take that path. Scrubbed members of the surgical team frequently are touching the patient and are therefore putting themselves in circuit. The manufacturers of electrosurgical generators do not recommend that surgeons use the technique of “buzzing the hemostat”. However, it remains a commonly employed method of achieving hemostasis and there are techniques that can reduce the potential for being shocked. The techniques shown are for stainless steel electrodes. Helpful hints: Grasp the hemostat with a firm grip over a large surface Do not activate in open circuit – the pencil should be in contact with the hemostat before activating Use the cut waveform because it is low voltage and will not produce large bursts of energy Use the lowest power setting possible Do not put yourself in the circuit. * Surgical smoke is called by a variety of names, including cautery smoke, diathermy plume, plume, smoke-plume, aerosols, bio-aerosols, vapor, and air contaminants. It can be seen and smelled (Figure 2). Surgical smoke is the result of the interaction of tissue and mechanical tools and/or heat producing equipment such as those that are used for dissection and hemostasis. Both the visible and the odorous components of surgical smoke are the gaseous byproducts of the disruption and vaporization of tissue protein and fat (Ott, 1997). Ott, D. E. (1997). Smoke and particulate hazards during laparoscopy procedures. Surgical Servic