ELECTRO SURGICAL UNIT DIATHERMY

What is about the unit?

It is a high frequency electric current producing machine generates enough heat to cut, coagulates and destroys body tissue

ELECTRO SURGICAL UNIT DIATHERMY

OBJECTIVE: Describe the safe use of a monopolar and bipolar Electrosurgical unit. Describe the effects of electrosurgical unit. Describe the dangers of Electrosurgical unit.

ELECTRO SURGICAL UNIT DIATHERMY

The Machine consist of 4 important units:
Electrosurgical Generator

Active Electrode
Dispersive electrodes

1. Electrosurgical Generator.

ELECTRO SURGICAL UNIT DIATHERMY

Different model have its own manufacturing instructions but basically, All generators will have the following: Cable for power sources On/Off switch to flow power through active electrode. A dial for selecting coagulation, cutting or blend dials and to select the amount of current for cutting or coagulation mode. A receptacle for the dispersive electrode cable or indifferent plate. A receptacle for active electrode cable A receptacle for the foot control

ELECTRO SURGICAL UNIT DIATHERMY

2. Active Electrode Active electrodes are used by the surgeon to accomplish the desired function. They comes in various sizes and styles, may be useable or disposable and may be hand control or foot control. 3. Dispersive Electrodes These may be useable metal plates, lead plates, disposable aluminum foil or flexible rubber type of plates which can be moulded to the thigh or calf and secure with bandages and lastly the pregelled type dispersive plates

TYPE OF ELECTRO SURGICAL UNIT

1. Monopolar Unit
The inactive electrode is in the form of a patient grounding pad or plate which is placed in direct contact with the skin. Current will flow from the active electrode through the body to the inactive electrode. The current then returns to the diathermy via the conductor cord to complete the circuit.

2.Bipolar diathermy
The active electrode is in the inner side of the forcep and the inactive is in the others side. The current flows from the unit through the active side,arcs through the tissue to the inactive

side and returns to the unit via the same cord.

The current does not disperse through the patient.

SUGGESTED SITES FOR PLATE PLACEMENT

CALF UPPER ARM ABDOMEN MID BACK BUTTOCKS ANTERIOR & POSTERIOR THIGH

Pad Site Burn

AORN Journal, March 1991

The safe operation of An ESU

Responsibilities before operating: Generator: 1. 2. 3. 4. 5. 6. 7. Know which electro-surgical to be used and how to use it. Read the instruction manual Only use equipment that is designed and approved for the unit. Do not use an ESU with damaged and missing parts. Report lost items or items not working properly. Ensure alarm system is working. Do not use top of the units as a storage area. Do not use ESU if explosive anesthetic agent is in use.

The safe operation of An ESU

Responsibilities before operating:

Dispersive Electrode or Indifferent Plates

1. 2. 3. Do not use metal plates that is cracked, bent or corroded. Do not cut, crease, or sharply bent a disposable plate. Apply enough gel evenly and smoothly over the entire indifferent plate for the good conductive. Use the recommended gel.

The safe operation of An ESU

Responsibilities before operating: Positioning of Dispersive Electrode: 1. Avoid body protuberances, skin folds, scar tissue, excessively fatty or hairy area, sites to be X-rayed or skin leison of any kind. Avoid sites where fluids might pool Ensure the dispersive electrode is in good contact with the patient and properly positioned. Ensure no skin surface in touching any metal parts of the table and its accessories The ESU should be far away from the ESU electrodes.

2. 3.
4. 5.

The safe operation of An ESU

Responsibilities before operating: Positioning of Dispersive Electrode (continue) 6. 7. 8. 9. Ensure the grounding cable is firmly connected to the dispersive electrode. Ensure flammable preparation solution have dried thoroughly. Place foot pedal / hand control in position for use by the surgeon. Turn the unit on and set the dials at the desired setting. (setting differ with each separate ESU, you must follow the manufacturer's instructions)

The safe operation of An ESU

Responsibilities during operating: The following precaution should be observed when using the ESU. 1. 2. 3. 4. 5. Position all cords so that they do not present a tripping hazard. Do not wheel equipment over the cords. If the patient is repositioned, recheck the dispersive electrode for proper patient contact. Recheck the grounding cable connections. If a second electrode is applied due to some fault, the first one must be removed. Ensure the active electrode clean at all times during surgery. Escher build-up increases resistant, reduce performance and require higher settings. Keep the active electrode separate from all conductors on the sterile field.

The safe operation of An ESU

Responsibilities during operating: The following precaution should be observed when using the ESU. 6. An unused active electrode should be placed in a protective sheath of pocket. It should never be placed where is can be activated accidentally and so burns the patient or medical personnel. Do not coil the active or patient cable as this causes cracks in the cable, leading to leakages of current and so constitute a potential danger to the patient. Do not activate the electrode-surgical unit for a long periods of time. If the plate or foil dispersive electrode is used for a long procedure, check for gel dry-out. Re-gel is necessary.

7.
8. 9.

The safe operation of An ESU

Responsibilities after operating: The following must be done: 1. Disconnect the unit in the following orders: - Turn the dials to 0 - Turn the power switch off - Disconnect the cable from active electrode by grasping the plug not the cable. - Disconnect the cable from the dispersive/ground electrode by grasping the plug. 2. Remove the dispersive electrode. - When removing metal plate lift the patient lightly and do not pull on the cable to remove the plate.

The safe operation of An ESU

Responsibilities after operating: The following must be done: - When removing metal plate lift the patient lightly and do not pull on the cable to remove the plate. - When using self-adhering dispersive electrode, gently support the skin surface and peel the adhesive back slowly to remove it. - Check the dispersive electrode site for signs of the skin damage.

Cont.
- Document skin condition. - Wipe all reusable parts with a damp cloth. - Remove all gel thoroughly from the metal electrode and wipe it dry. - Do not bend or kink electrical cords, coil them loosely. - Sterile the accessories with sterrad (hydrogen proxide), if possible to prolong life. The active electrode can also be steam sterile.

THANK YOU