Covidien 电外科安全讲座.pptVIP

* * Surgeons worry about accidental burns to tissue edges from the noninsulated portion of the shaft of the active electrode tip. In order to prevent this from happening it is a common practice to shield the tip with a piece of red rubber or other material such as steri-strips or needle electrode plastic covers. The ECRI warns against this practice. Besides altering a medical device, sheathing materials can serve as a fuel source and may ignite during the procedure. Electrodes that come pre-shielded are available from ESU manufacturers. Manufacturer insulated electrodes must be kept free of eschar build-up and used according to the manufacturers instructions. * * Radio frequency current, unlike the 60 cycle current from the wall outlet, can and does “leak” through the insulation on the cord or electrode. No matter how thick the layer of insulation is, there will be some current leakage with the use of this high frequency current. The higher the voltage, the more insulation it can overcome, resulting in a higher amount of leakage current. Consequently, avoid wrapping active electrode cords around metal instruments and bundling cords together. * * If the patient has an external or internal pacemaker, use electrosurgery with extreme caution. The electrosurgery generator can cause pacemakers “to enter an asynchronous mode or can block the pacemaker effect entirely”. Before using electrosurgery on a patient with a pacemaker, consult with the pacemaker manufacturer or facility cardiology department. Bipolar electrosurgery is the preferred modality for the patient with a pacemaker, because of lower voltages needed to push the bipolar current through the patient’s tissue. Apply the return electrode so that the current will flow between the active electrode site to the return electrode without passing through the area of the heart or pacemaker implantation site. Ensure that the distance between the active and return electrode sites is as short as possible, but as fa