Dateiname mit Revisionsstand:
erstellt am:
erstellt von:
geprüft von:
freigegeben von:
Seite
ESU-X 300NT_EN B
18.04.2018
ssta
cgro
cgro
4 von 35
GYNAECOLOGY, HEART SURGERY, ORTHOPAEDICS, NEUROSURGERY,
OTORHINOLARYNGOLOGY,
UROLOGY,
MAXILLOFACIAL
SURGERY,
DERMATOLOGY, PLASTIC SURGERY, VASCULAR SURGERY, GENERAL AND
THORACIC SURGERY, PAEDIATRIC SURGERY, EMERGENCY SURGERY,
GASTROENTEROLOGY, VETERINARY, AND OTHER
.
GENERAL PRECAUTIONS
– It is dangerous to ignore the following warnings!
1
Every electro-surgical unit has its own characteristics and therefore, before using it, it is advisable to check its
functioning, without taking into consideration the previous experiences with other devices only. Anyway, start
always with very low powers, and then raise them until the required one is reached;
2
It is extremely dangerous to use the device if the electrical plant and the installations of the operating theatre
do not comply with the current safety standards. Never use extensions for the mains cable and, if many devices
are connected at the same time, ask for their compatibility to the Technical Service;
3
It is extremely dangerous to use accessories or instruments which are not perfectly compliant with all the
applicable technical or legislative Rules, and which are not suitable for the working voltages of the device
(approx. 7600Vpp “4000Vp” for the monopolar currents with crest factors equal or higher than 2; 3600Vpp
“1800Vp” for the monopolar currents with crest factors lower than 2; approx. 1100Vpp “550Vp for the bipolar
currents with crest factors equal or lower than 2). Moreover, the accessories and instruments must not be old
nor worn. Check always their status before the use, notably if for endoscopy. Bear in mind that:
-
All the old/worn active electrodes, accessories and cables do not work properly, and do not guarantee the
perfect insulation. In addition, their unstable functioning can lead the operator to increase the output
powers at dangerous levels;
-
In the user manual, for each current, the maximum output voltage “Vpp” and its variation (see the curves)
according to the output power adjustment are specified. This allows the operators to choose the maximum
output power that must not be overcome, in order to not exceed the rated HF insulation voltage, which is
possible for each accessory;
-
The standard monopolar active electrodes for normal surgery have a stem with Ø 2.3mm (so, the standard
electrode-holder handles are suitable for the electrodes having stems with this diameter).
4. Do not activate the outputs before the active electrode is in contact with the tissues, as electrical arcs can be
created. They burn the tissues superficially and prevent the good effect ;
5. Keep the active electrode always clean, because otherwise it can provoke sparks or superficial carbonizations
on the tissues. A dirty active electrode, an electrode in bad conditions, or an electrode with connection defects
causes a reduction of the output power, as it does not have any good contact with the tissues;
6. Remember that, even if compliant with all the current standards about the electromagnetic compatibility, the
unit can have interferences with other electro-medical equipments;
7. Bear in mind that, when operating on patients with pace-makers or other implanted active devices, an
interference with their functioning can occur (fibrillations, etc.), and they can even be damaged (in this case, it
is advisable to ask for a specific qualified advice from the Cardiology Division);
8. Never use an electro-surgical unit in presence of flammable anaesthetic gases (i.e. oxygen and nitrogen
protoxide, etc.), notably when operating in cavities like thorax, abdomen, trachea, head, etc. Do not use any
cleaning substances, disinfectants or flammable solvents; if used, let them evaporate before the intervention.
Always remove their remaining traces from the hollow parts of the body or the cavities (i.e. umbilicus, vagina,
etc.), and from underneath the patient. Remember that during the use a spark may cause the explosion of
endogenous gases (intestine), or the fire of oxygen saturated materials (cotton, gauze, etc.);
9. Take always all the metallic objects off the patient (rings, etc.), and be sure he is not in contact with any metallic
part connected to the earth, or which may conduct electricity (table, supports, etc.). Insulate with dry towels the
strongly secreting parts of the body and the contacts skin-to-skin (i.e. between the arm and the body);
10. Place always all the monitoring electrodes, which are not specifically protected, as far away as possible from
the electrodes of the electrosurgical unit. It is not advisable to use needle type or very small monitoring
electrodes;
11. Use and place the neutral electrode as follows:
-
Bear in mind that, if the neutral electrodes “Split” type double section are not used, the neutral electrode
safety circuit of the unit cannot control the contact between the electrode and the patient tissues (that is,
it does not grant the safety of a good contact);
-
Make sure it is in perfect conditions (the worn/old neutral electrodes are extremely dangerous for the risk
of the burns on the patients), and choose an area of the body as close as possible to the intervention point
(the ideal would be a soft part without hairs, nor protuberant bones or superficial differences). Clean this
area, shave it and massage it, in order to favour the circulation;
-
Fix it in a reliable way, without placing anything in-between, nor pressing too much, in order to avoid
ischemic zones. Establish the best possible contact over the entire surface, and make sure it remains
constant, especially if the patient is moved or when liquids are poured. As a matter of fact, a non
homogeneous and/or insufficient contact of the neutral electrode generates both an increase of the current
density in the contact points (which produces a higher temperature into the tissues, and creates burns),
