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ESU-X 500TT_EN B
01.06.15
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ELECTRO
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MAGNETIC INTERFERENCES
The unit complies with all EMC standards, but it can, mainly during the monopolar use, damage the functioning
of:
Other devices used in O.T. (i.e. monitoring devices, video
‐
cameras, and so on). To reduce this problem,
connect the ESU to a mains socket different from that used to supply these devices and, if necessary,
ask for qualified technical assistance.
Pace
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makers, neuromuscular stimulators or other implanted devices when operating on patients with
these devices, ask for qualified advice from the Cardiology Division. Remember that the bipolar mode is
the best solution to operate these patients.
PREPARING AND POSITIONING OF THE PATIENT
Operators, when use a HF unit, must avoid all causes which can badly affect the path of the current and the
related thermal effect inside tissues because they cause the following risk.
Burns of the patient’s tissues where
the density of current is too high. For example:
An implanted metallic prosthesis concentrates the passage of the current in the surrounding tissues.
Damp/wet sheets placed under or around the patient and the metallic trocars for laparoscopy can cause
an anomalous passage of the current.
To reduce this risk users must do the following:
Take all the metallic objects off the patient (rings, etc.), remember also that the metallic elements
(prosthesis, catheters, etc.) on the path of the current may cause increases of density of current;
When performing a laparoscopic procedure, check the insulation of trocars and instruments;
With dry sheets or other suitable materials insulate the patient from any metallic part connected to earth
or which may conduct electricity (operating table, supports). In the same way insulate the patient from
the heating mattress and the secreting parts of the body or the contacts skin
‐
to
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skin (i.e. between arms
and body). Remember that also the sweat can affect the insulation. During the operation, mainly if the
patient is moved or liquids are poured, verify if the insulation remains good.
When
preparing the operating field, don’t use flammable disinfectants and take care that the used
disinfectants do not wet the sheets positioned under or around the patient. Also dry the traces of
disinfectant on the skin.
Place all the not specifically protected monitoring electrodes as far away as possible from the electrodes
of the HF unit. Avoid, if possible, the use of needle type or very small monitoring electrodes.
USE OF THE NEUTRAL ELECTRODE
When using monopolar currents, the bad contact of the neutral electrode causes two specific risks:
Burns on the tissues where the neutral electrode is fixed because the passage of the current is not
homogeneous (it flows through areas with better contact and worse contact) and it produces, in the
areas with better contact, a thermal effect so high to cause burns.
The bad functioning of the HF unit which leads users to raise the delivered powers and increases, in this
way, the risk of burns where the neutral electrode is positioned (higher power = higher risk).
In order to obtain the best and homogeneous contact, choose, use and place the neutral electrode (NE) as
follows:
Check that the NE, if it is a reusable type, is not either worn or damaged.
Place it on an area of the body as close as possible to the intervention point (the ideal is a soft part
without hairs, protuberant bones or superficial differences), but which not get wet both when preparing or
disinfecting the operating field and during use. Clean this area, shave it and massage it in order to
improve the circulation. Normally, the better points are calf and thigh, but obviously if the operation does
not affect these areas.
Fix the NE properly with the best possible contact, without placing anything in between, but do not press
it too much, in order to avoid ischemic zones. Avoid anomalous contacts (i.e. When positioning the
patient’s arm on the operating table, insulate the hand/ the fingers from the neutral electrode).
When preparing and disinfecting the operating field, avoid wetting the NE or the related area.
During use, mainly if the patient is moved or liquids are poured, verify if the intended contact remains
constant.
For the choice, according to specific needs) of the best “disposable” NE; contact the Technical Service.
Use a disposable NE only once and follow its instructions. The right dimensions are approx. 136cm2 for
patients with body weight higher than 15 Kg; approx. 84cm2 for children with body weight from 5 to 15
Kg. When using adhesive NE, do not rely on their characteristics only. The use of a supplementary fixing
grants a more reliable contact (i.e. an elastic bandage, able to cover the entire NE, but without pressing
it too much).
