Safety with the Electrosurgery Generator

Protection Against Low Frequency Electric Shocks

The "electric shock", associated with the domestic mains supply, is caused by the stimulating nature of the low frequency alternating current (commonly 50 Hertz). The electrosurgery generator, by use of special transformers and optical isolating devices, ensures that dangerous levels of the low frequency current cannot reach the patient or operator. Cardiac arrest, fibrillation or respiratory arrest could result from malfunctioning equipment without such isolation.

Most generators cannot detect bad or loose connections in the active electrode, which could result in higher than normal low frequency components in the electrosurgery current. Low frequency current components can cause fibrillation, and it is advised that the patient plate (dispersive electrode) is placed so that the electrosurgery current will not pass directly through the region of the heart.

Safety Guidelines in the Use of Electrosurgery

Routine safety checks are essential - read and learn the Do's and Don't's for the correct use of electrosurgical generator and associated accessories:

DO's

1. Place the patient plate as close to the surgical site as possible, with as much smooth surface contact as possible.
2. Place any monitoring electrodes (i.e. ECG) as far as possible from the active electrode to patient plate electrosurgical current path.
3. Locate the patient plate over well vascularised muscular areas.
4. Avoid unnecessary or prolonged activation of the electrosurgical unit.
5. Keep active electrode tips clean and free of debris during use. Eschar or carbon adhered to the electrode prevents proper current flow necessitating high power settings.
6. Check patient plate and all connections during surgery if constant power level increases are required.
7. Read the Instruction Manual thoroughly before using the equipment for the first time.
8. Schedule routine preventive maintenance of all electrosurgical equipment, and follow equipment "Systems Check" on a regular basis.

DON'T's

1. Never use electrosurgery in the presence of explosive or flammable anesthetics, fluids or gases. Normal electrosurgery produces sparking at the active electrode, which could ignite those gases or liquids.
2. Do not use uninsulated active accessories, or instruments on which the insulated coating has been broken. Use only insulated forceps, endoscopic sleeves and eyepieces. Cords and cables which have broken, split or in any way damaged must be replaced, not repaired.
3. Don't re-use disposable accessories. These can seldom be properly cleaned.
4. Don't locate patient plate over bony or hairy areas, scar tissues or implanted prostheses. A bad contact could result and cause patient burning.
5. Never allow pools of any fluid to accumulate at either active electrode or patient plate. This can cause unnecessary tissue destruction or patient burning.
6. Don't cut the patient plate to reduce the size at any time.
7. Don't use unmonitored plates on electrosurgical equipment with monitoring facilities. Protection given by the machine would be lost.
8. Don't use bent, crumpled or torn patient plates, or any plate which in any way has suspect conductivity or patient contact.
9. Do not allow any cables to become knotted.
10. Never "test" the output of the machine by touching the active electrode to ground.
11. Do not place the active electrode on a grounded surface when not in use.
12. Never contact two active monopolar forceps simultaneously.