Covidien电外科安全的讲座.ppt

* Radio frequency current, unlike the 60 cycle current from the wall outlet, can and does “leak” through the insulation on the cord or electrode. No matter how thick the layer of insulation is, there will be some current leakage with the use of this high frequency current. The higher the voltage, the more insulation it can overcome, resulting in a higher amount of leakage current. Consequently, avoid wrapping active electrode cords around metal instruments and bundling cords together. * If the patient has an external or internal pacemaker, use electrosurgery with extreme caution. The electrosurgery generator can cause pacemakers “to enter an asynchronous mode or can block the pacemaker effect entirely”. Before using electrosurgery on a patient with a pacemaker, consult with the pacemaker manufacturer or facility cardiology department. Bipolar electrosurgery is the preferred modality for the patient with a pacemaker, because of lower voltages needed to push the bipolar current through the patient’s tissue. Apply the return electrode so that the current will flow between the active electrode site to the return electrode without passing through the area of the heart or pacemaker implantation site. Ensure that the distance between the active and return electrode sites is as short as possible, but as far as possible from the pacemaker site. Do not lay the active electrode or cord across the pacemaker. When activated, leakage current may inadvertently cause the pacemaker to activate. AORN, Standards, Recommended Practices, and Guidelines, 2007 Edition, Denver, CO: AORN, p 522. * This slide shows some of the type of injuries that can occur during electrosurgery. Today we will focus primarily on the potential for alternate site and patient return electrode site injuries. * “All matter is made up of atoms. Atoms consist of electrons (negatively charged), protons (positively charged), and neutrons (neutral) particles. Atoms that contain equal numbers of electrons