Patient Safety using an Electro-Surgical Unit

Posted at 05 February 2024 in Electro Surgical Unit,Patient Safety by Marrianne

Patients rely on healthcare facilities & health professionals to look after them during their surgical journey. The aim is to leave a healthcare facility in a more optimal state than when they were admitted.

In the OR an electro surgical unit is used in 80% of surgical cases, this involves an electrical current that can be localised- Bipolar (cautery), or is an electrical circuit- Monopolar. Incidences of electro surgical injuries according to research are under reported.

Monopolar is an electrical current that flows through the patient and requires a patient return electrode which connects to the electro surgical unit.

Thermal injury is a result of a burn from the use of electro surgery. This is why jewellery, piercings and any metal implants should be flagged with the peri-operative team, prior to surgery.

Laparoscopic cases have been show to increase the incidence of a surgical burn injury.

Research suggests that 3.6 per 1,000 laparoscopic procedures may result in a burn injury.

Electro surgical units are also a fire source, they are commonly referred to as a fire stick.

“It is currently estimated that around 500 to 600 surgical fires occur annually in the United States”, this impacts on patient safety but also impacts on healthcare facilities, costing them ‘millions of dollars annually”.

In order to reduce surgical burns the surgical team are responsible for assessing equipment & instruments prior to all surgical cases.

It is important that all surgical instruments are checked prior to use, to prevent thermal injuries, particularly in laparoscopic/robotic cases, where the insulation of laparoscopic instruments can become worn and compromised.

Leads & connections should also be checked.

Patient positioning is also extremely important so that no body part is touching any metal, especially in lithotomy and prone cases.

There are other safety precautions healthcare workers need to be mindful of, including prep solutions- pooling, alcohol and the use of oxygen, especially in the airway.

Pacemakers and any metal implants should also be flagged with the peri-operative team, in order for them to prepare the right equipment in advance of the surgery.

Depending on the type of surgery, bipolar may be a safer option.

Lets educate & support our healthcare workers

Educating and supporting clinicians is vital to empowering and informing best and safe practice.

Training & education requires time by employees and employers.

The value in supporting electrosurgery education benefits the facility by empowering and encouraging safe practice in addition to increasing a clinicians level of competence and understanding, all of which impacts, on safe surgical care & outcomes.

References

https://pubmed.ncbi.nlm.nih.gov/30472721/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7456630/

https://www.jscimedcentral.com/jounal-article-info/Journal-of%C2%A0Dermatology%C2%A0and-Clinical-Research/Peri-Operative-Management-of-the–Patient-with-Body-Piercings-8253