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