KWIPPED TIP: Renting an electrosurgical unit

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Electrosurgical units are used by medical professionals for endoscopic therapeutic procedures. Common procedures include cardiac, orthopedic, urological, dental, and spine procedures. Electrosurgery bases itself on the ability to transform electric current into high heat with expectations to cut/or coagulate tissue upon application. There are two types of output: mono-polar output, where the current will flow from the surgical site to the unit by using a return electrode. The second type is bipolar output, where there is no return electrode used. This type is typically used for more precise and delicate procedures.

Most electrosurgical units offered today offer basic features including current waveforms, blended currents, and CQM. Some ESU models provide modes for alternate and coagulation phases. Some systems include a closed loop feedback system which allows adaptation of the current according to continuous measurements made during the actual procedure.

Use a newer model.

Newer electrosurgical models are a necessity for performing standard procedures. Some key features to look for when renting are the following:

  1. The device should manufactured after 1970. ESUs with “spark gap technology” can be quite hazardous to use with other technologies in the medical settings.
  2. Ground referenced, or “grounded” electrosurgical units are more than obsolete and should replaced by isolated and return monitoring systems.
  3. Newer electrosurgical units have many safety features that enable more stability and reliability. Some of these features include enhanced bipolar outputs, and neutral electrode safety monitoring.

Check these key settings first.

Before using your rented electrosurgical unit, make sure to check the device for damage. All cables and electrodes should have sufficient insulation. Depending on the type of procedure you’re using the ESU for, the power settings should be adapted accordingly. Adjust the power settings to make sure they’re in working order. If the electrodes, forceps or scissors seem in disrepair, do not try to repair while active. Check the power switch in case of an in-procedure emergency.

Other considerations.

Patient neutral electrodes (plates or grounding pads) need to be cross referenced to the ESU manufacturer. The neutral electrode should be attached to skin that is clean, dry, and free of hair. Always check the expiration date of patient plates to prevent burning of the skin. It should be cut to the appropriate size depending on the patient’s weight—not size.

The size of the electrosurgical unit needs to be taken into consideration. If you have a smaller endoscopy room, your unit will need to reflect that. In general the parameters for waveform, power settings, type of active electrode and length of current delivery should be priority when determining the quality of cut or coagulation of tissue.

Electrosurgical Unit Safety.

  • In the presence of a pacemaker or defibrillator, seek advice from an authority before procedure.
  • If a current is not required, keep the pedal clear from accidental pressing.
  • When applying current, remember to use gloves.
  • ESU need to be completely grounded to remove interference with other systems.
  • Always wear surgical masks and have sufficient ventilation during procedure.
  • Always read the manufacturer’s guidelines and manual before usage.

Common manufacturers:

Common manufacturers of anesthesia machines include Braun, EMED, Coviden, Bowa, Elektro-mag, KLS Martin, XO, Zerone Co., Nico, and Alan.

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