Without reference, identify principles about Electrosurgical Units with at least 70

percent accuracy.

Purpose of an Electrosurgical Unit (ESU) ◦ A system that uses radio frequency to

Sever tissue Stop bleeding (hemeostasis)

◦ Units operate in the range of 300 kHz to 3 MHz

Electrosurgical Unit

Types ◦ Monopolar

Active electrode - one side of the generator The electrosurgical effect takes place at the active

electrode only Typically offers the best alternative for wide surface

coagulating and dissection of tissue Return electrode

The other side is known as o patient plate o Reference electrode o dispersive electrode

Electrosurgical Unit

No electrical effect is intended or desired Needed to complete the electrical circuit Placement

As close as possible to the surgical site Minimize the distance that the current will need to

travel through the body

◦ Bipolar Both sides of the generator are connected to a

surgical handpiece Allows for better current control The current passes between two poles of a

forceps rather than through the entire body

Electrosurgical Unit

Surgical Effects and Operational Modes ◦ Coagulation

Used to control or stop bleeding It is a low power technique Uses an interrupt current to supply controlled dehydration Can also be used for destroying undesirable tissue

masses ◦ Cutting

Heats tissue so rapidly that cells explode and contents vaporize leaving an incision

When used, the electrode is separated from the tissue by a thin layer of steam

Used like a stainless steel scalpel Little or no control over bleeding

Electrosurgical Unit

◦ Blend Hybrid of cut and coagulate Used when surgeon desires more hemeostasis effect than cut

provides This mode saves time, as only one pass with electrode is

necessary ◦ Spray (fulguration)

Used for rapid control of bleeding across a wide area A non-contact type of coagulation The current sparks or jumps from active electrode to the

tissue Uses

To destroy surface layers of cells in the bed from which a lesion has been removed

Ideal for sealing off hidden bleeders due to their path of least resistance

Electrosurgical Unit

Power◦ Can be varied for all modes◦ Setting depends on tissue type, procedures, and the

type of electrode used◦ Low power

Neurosurgery Oral

◦ Medium power General surgery Abdominal opening

◦ High power Open the chest Mastectomies

Electrosurgical Unit

Precautions ◦ Return plate burns

Protect the patient from being burned The pad must have as much direct contact with the

patient as possible Edge effect – use a pad that has a larger edge to lower

current density Monitor Systems

Used to prevent a patient from a pad related burn The ESU is designed to send a small current up one side

of the pad through the patient’s skin and back through the other side of the pad

If the ESU senses a change in resistance from the pad to patient contact it will set off an alarm

Electrosurgical Unit

◦ Alternate current path burns When the pencil is activated there is

opportunity for RF leakage interferenceWrapping surgical cable around metallic material and

securing it to a flammable material may lead to a fire hazards

You need to be aware of the hazards of RF leakage and choose products that are shielded properly from these hazards

Prevent electrical shockKnow the basic principles of electricity, current

density, and the path of least resistanceNever activate in open circuit

Electrosurgical Unit