Properly Operating Electrosurgical Equipment Medical personnel employing the use of electrosurgical equipment should receive training and have a general knowledge of the principles of operation. Taking safety measures will minimize the safety risks to personnel and patients alike. If a problem does occur, corrective measures should be taken to prevent future mistakes from occurring. Some common problems related to electrosurgery include fire, injury, and tissue damage.
Taking Proper Precautions Any equipment or accessories should be examined before, during, and after use to make sure that continued use is medically safe. Operators of the devices should be instructed and briefed on the proper operation, care, and handling of the unit and the accessories. Incorrect use of the devices could easily result in serious injury to both patients and personnel. If there is more than one type of electrosurgical equipment present and in use, the staff should be trained so that they are qualified and capable of using the equipment in the clinical setting. Staff should be instructed on the risks associated with minimally invasive procedures. One problem associated with procedures is direct coupling. Direct coupling happens when laparoscopic active electrode touches another anatomic structure. When this happens, necrosis occurs in underlying tissue. If a trauma occurs during use of the device or during reprocessing, it can cause the laparoscopic electrode to have insulation failure. This alternate pathway can allow the current to leave the electrode, which may result in serious injury. This is especially true if the injury is internal. Undetected burns to nearby tissue and organs outside the endoscope’s viewing field could be a result of capacitive-coupled RF currents.
Excuse me, Nurse? Registered nurses who specialize in perioperative practices should have knowledge about the various types of implanted electronic devices used in the clinical setting. They must also be knowledgeable of the safety precautions that must be taken when caring for individuals with these units and their accessories.
Implanted electronic devices may be affected by one another if more than one is being used on a patient at one time. Other medical equipment may also cause interference if they come in contact with one another in a health care facility. The administrative heads within the health care facility should assess and document annual competency of personnel in the safe use of the electrosurgical unit and its accessories. This assessment will document and ensure that each person using the devices is qualified and competent. It is important that each individual who handles the devices and its accessories have a basic understanding or electrosurgery, its risks, and know the corrective actions to take if a problem does arise. Knowledge of these things will provide a safer environment and help minimize the risks of equipment that is improperly handled. Nursing activities should be thoroughly documented on a regular basis to ensure clear and correct communication between health care professionals, patients, and state boards. Records should include patient assessment, an attending plan, nursing diagnoses, identification of desired outcomes, interventions, and an evaluation of the patient’s response to the care provided.
Better Safe Than‌ Having all of this information available will ensure that all health care providers with the facility are on the same page in regards to patient care and procedures. This type of seamless tending will help make sure that the facility provides the best and most consistent care possible. In order to make sure that everyone knows how to and can efficiently read the documentation of patient care, records should be logged in a consistent manner that complies with health care organization policies and procedures. Just as medical personnel need to be trained to attend the patient, they need to be trained to write in charts and records and be trained on how to read them. Some of the records that need to be documented thoroughly will include information about the electrosurgical device. Personnel should record the electrosurgical system identification serial number, the range of setting used, and the dispersive electrode placement. Personnel should also record the condition of the patient’s skin before the placement of the dispersive electrode, and again after dispersive electrode is removed. It should also be recorded which adjunct electrosurgical devices used, like the ultrasonic scalpel or the bipolar forceps, and if a holster was used.