Lakhasly

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It's another safety feature whereby the electric, the Electro surgical generator or dye thermal
unit has been described as the most hazardous device used on a daily basis in the operating
theatre.We will deal firstly with monopolar electrosurgery, having established that the high
frequency AC prevents neuromuscular stimulation.You should ensure that a well vascularized muscle mass is chosen and that you avoid
areas of vascular insufficiency, irregular body contours and Bony prominences and also consider
the incision site and prep area, the patient position and other equipment on the patient.The voltage used in cut is substantially lower than in coagulation mode, with peak voltages
ranging from approximately 1300 to 2300 volts to give the hemostasis associated with
coagulation.Electro surgical generators deliver a much higher frequency, around
400 to 500 kHz and it is this that prevents neuromuscular stimulation and allows the current to
pass safely through the body.Coagulation is useful where tissue is oozing and may be used to
desiccate tissue, where the instrument is used in direct contact with the tissue or full grade
where the voltage is increased, the instrument held slightly above the tissues and the sparks
allowed to jump across the gapLow frequency current such as the
mains, which alternates 50 times per second or at 50 Hertz, leads to neuromuscular stimulation
and potential cardiac arrest.Therefore, should the patient return electrode become detached from the
skin, the current may leave the body by any number of routes, for example the operating table
or ECG electrodes, causing burns at these points due to current concentration.With this in mind, we will take a few minutes to tell you about the hazards involved in
using Electro surgical equipment, give you an insight into how it works and give you some basic
knowledge to encourage practice in the theatre.The key factor that allows the use of Electro surgery is that the current
from the generator is high frequency alternating current.Most Electro
surgical generators in the UK are what is termed isolated.The major potential hazard with the
older style of grounded generators is that the current flowing through the patient will not
preferentially look for the patient return electrode to complete the circuit.Remember that
although you as the surgeon may not apply the patient return electrode, it is your responsibility
to ensure that it is properly applied, so you should be aware of some basic principles relating to
the pad.There are two important differences between these the time the current is actually
supplied by the generator and the voltage to achieve the precise clean cut one gets.There are two methods of applying electrosurgery, monopolar and
bipolar.However, if the system you are using
is not an isolated one, you must take special care to ensure the patient return electrode is
properly applied and checked throughout the operation.


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Please I want a summary of this


It's another safety feature whereby the electric, the Electro surgical generator or dye thermal
unit has been described as the most hazardous device used on a daily basis in the operating
theatre. With this in mind, we will take a few minutes to tell you about the hazards involved in
using Electro surgical equipment, give you an insight into how it works and give you some basic
knowledge to encourage practice in the theatre.
So how does it work? How can we pass high voltage at a relatively high current through a patient
without killing them? The key factor that allows the use of Electro surgery is that the current
from the generator is high frequency alternating current. Low frequency current such as the
mains, which alternates 50 times per second or at 50 Hertz, leads to neuromuscular stimulation
and potential cardiac arrest. Electro surgical generators deliver a much higher frequency, around
400 to 500 kHz and it is this that prevents neuromuscular stimulation and allows the current to
pass safely through the body. There are two methods of applying electrosurgery, monopolar and
bipolar. We will deal firstly with monopolar electrosurgery, having established that the high
frequency AC prevents neuromuscular stimulation. It is not an earthing device. Most Electro
surgical generators in the UK are what is termed isolated. However, if the system you are using
is not an isolated one, you must take special care to ensure the patient return electrode is
properly applied and checked throughout the operation. The major potential hazard with the
older style of grounded generators is that the current flowing through the patient will not
preferentially look for the patient return electrode to complete the circuit. It is equally happy to
flow back to earth. Therefore, should the patient return electrode become detached from the
skin, the current may leave the body by any number of routes, for example the operating table
or ECG electrodes, causing burns at these points due to current concentration. Remember that
although you as the surgeon may not apply the patient return electrode, it is your responsibility
to ensure that it is properly applied, so you should be aware of some basic principles relating to
the pad. You should ensure that a well vascularized muscle mass is chosen and that you avoid
areas of vascular insufficiency, irregular body contours and Bony prominences and also consider
the incision site and prep area, the patient position and other equipment on the patient. What
modes of Electro surgery are you aware of? Let's look at the two common modes, cut and
coagulation. There are two important differences between these the time the current is actually
supplied by the generator and the voltage to achieve the precise clean cut one gets.
In the pure cutting mode the power is on 100% of the time, leading to rapid and extreme heating
of the tissues which vaporizes cells. Pure cutting current is used, for example, to open the skin.
The voltage used in cut is substantially lower than in coagulation mode, with peak voltages
ranging from approximately 1300 to 2300 volts to give the hemostasis associated with
coagulation. The power is delivered in pulses and is actually on for only about 6% of the time.
This results in much less heat generation, so instead of being vaporized, the tissue is heated
more slowly and chars. Coagulation is useful where tissue is oozing and may be used to
desiccate tissue, where the instrument is used in direct contact with the tissue or full grade
where the voltage is increased, the instrument held slightly above the tissues and the sparks
allowed to jump across the gap


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