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ABSTRACT: Electrosurgical equipment is widely used in operating theatres for haemostasis and destruction and division of tissue during surgery. Recommended best practice around the appropriate positioning of disposable diathermy pads and their use with implanted electronic devices is discussed to ensure patient and staffsafety.
KEYWORDS: Electrosurgery, electrosurgical unit, diathermy, dispersive electrode pad, Perioperative Nursing.
Introduction
Following best practice guidelines for correct placement and usage of disposable diathermy pads is essential in order to reduce and prevent injury within the perioperative environment for patients and staff.
The disposable diathermy pad is needed for procedures requiring the use of monopolar diathermy or, if an earthing pad on the operating table is in use, when the patient does not have sufficient contact with it.
The current passed into the patient through the probe needs to exit the body by means of the dispersive electrode pad. Should this be incorrectly used or if the patient is in contact with an alternative pathway to the ground, the current will take the pathway of least resistance. This can result in a number of adverse events including burns to the patient and staff(Spruce & Braswell, 2012; Australian College of Operating Room Nurses [ACORN], 2014).
Electrosurgery and diathermy machine usage
Electrosurgery is commonly used to attain haemostasis, destruction and division of tissue within surgical procedures. This occurs through an electrical current which produces heat, causing tissue destruction (Gallaher, Dhinsa & Miles, 2010). Two types of electrosurgery commonly used include bipolar or monopolar modes of delivery.
Bipolar electrosurgery uses forceps; one tip acts as the positive or active electrode and the other acts as the return electrode. Monopolar electrosurgery utilises one active electrode, therefore the current must exit the body by means of another route. This occurs either through the reusable pad on the operating table, or a metallised plastic diathermy pad (Lippincott, 2015). Both act as the ground electrode and are plugged into the electrosurgical unit. Failure to abide by recommended guidelines can result in injury to both patients and staff. Implementation of best practice guidelines aim to ensure that patients have optimal care within the operating suite to maximise health outcomes post operatively.
Potential Complications or risks of non-adherence
Within the operating theatre there are a number of potential risks to...