Electrosurgical Safety
Publication Date: July 29, 2020
Guideline for Electrosurgical Safety Recommendations
Injury Prevention
1.1 Assess the patient preoperatively for the presence of foreign bodies (eg, [implanted electronic device], jewelry, prosthetic implants).
1.2 Place patient monitoring electrodes (eg, electrocardiogram, oximetry, fetal) as far as possible from the surgical site.
1.4 During the use of monopolar devices, prevent contact between the patient and metal objects.
1.5 Remove all metal jewelry that will be between the active and passive electrodes.
1.6 Follow the manufacturer’s written instructions for use (IFU) for all ESU components.
1.7 Perform the following fire prevention interventions when using an electrosurgical device:
1.2 Place patient monitoring electrodes (eg, electrocardiogram, oximetry, fetal) as far as possible from the surgical site.
1.4 During the use of monopolar devices, prevent contact between the patient and metal objects.
1.5 Remove all metal jewelry that will be between the active and passive electrodes.
1.6 Follow the manufacturer’s written instructions for use (IFU) for all ESU components.
1.7 Perform the following fire prevention interventions when using an electrosurgical device:
• use technologies other than monopolar (eg, bipolar devices, coblation technology, non-energy-applying instruments) during surgical procedures on anatomical structures that present special fire hazards (eg, bowel, trachea);
• use moist radiopaque sponges near the ignition source;
• remove alcohol-soaked sponges or other application devices from the sterile field; and
• allow alcohol-based solutions to dry and fumes to dissipate before using any type of electrosurgical active electrodes.
1.9 When patient or personnel injuries or equipment failures occur during the use of an electrosurgical generator or accessories,
• use moist radiopaque sponges near the ignition source;
• remove alcohol-soaked sponges or other application devices from the sterile field; and
• allow alcohol-based solutions to dry and fumes to dissipate before using any type of electrosurgical active electrodes.
• remove the electrosurgical generator and accessories from service;
• retain all accessories and packaging if possible; and
• report the adverse event details, including device identification and maintenance and service information, according to the health care organization’s policy and procedures.
(Recommendation)• retain all accessories and packaging if possible; and
• report the adverse event details, including device identification and maintenance and service information, according to the health care organization’s policy and procedures.
335982
ESU Accessories
3.1 Use accessories that are compatible with the generator as specified in the manufacturers’ IFU.
3.3 Secure electrosurgical accessory cords to the sterile drapes
3.7 The electrosurgical generator foot pedal activation switch should be activated exclusively by the person in control of the active device.
3.9 When using an active electrode,
3.3 Secure electrosurgical accessory cords to the sterile drapes
• with a non-piercing plastic or other nonconductive device, and
• in a manner that does not crush or damage the cord or compromise the sterile field.
3.5 Visually inspect electrosurgical accessories for damage (eg, insulation breakage) before and after use and, if reusable, during reprocessing.
• in a manner that does not crush or damage the cord or compromise the sterile field.
3.7 The electrosurgical generator foot pedal activation switch should be activated exclusively by the person in control of the active device.
3.9 When using an active electrode,
• connect the cord directly into a designated receptacle on the electrosurgical generator;
• place the electrode in a clean, dry, nonconductive safety holster when it is not in use; and
• use only adaptors approved by the manufacturer of the ESU and the accessory.
3.10 Do not activate the active electrode until it is in close proximity to the surface if fulgurating, or in contact with the target tissue if cutting or coagulating. (Recommendation)• place the electrode in a clean, dry, nonconductive safety holster when it is not in use; and
• use only adaptors approved by the manufacturer of the ESU and the accessory.
335982
Recommendation Grading
Disclaimer
Overview
Title
Electrosurgical Safety
Authoring Organization
Association of periOperative Registered Nurses
Publication Month/Year
July 29, 2020
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adolescent, Adult, Child, Infant, Older adult
Health Care Settings
Hospital, Operating and recovery room
Intended Users
Surgical technologist, nurse, medical techologist technician, nurse practitioner, physician, physician assistant
Scope
Diagnosis, Prevention
Diseases/Conditions (MeSH)
D004598 - Electrosurgery
Keywords
electrosurgical units, ESUs, electrocautery devices, argon-enhanced coagulators, dispersive electrode