Electrosurgery Module 5 Quiz

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Questions and Answers

What should be avoided when using a dispersive pad?

Using low voltage waveforms

Placing it on tattoos (correct)

Using it with bipolar electrosurgery

Exposing it to high temperatures

Which is a recommended practice to prevent electrosurgical patient complications?

Employ brief intermittent activations (correct)

Activate instruments continuously

Wrap the active cord around objects for stability

Use the highest power setting available

What is the safest choice for cannula systems during electrosurgery?

Plastic-based hybrid systems

Silicone-coated cannulas

Non-metallic flexible systems

All metal cannula systems (correct)

Why should the electrosurgery instruments not be activated in open circuit?

It increases the risk of capacitive coupling Signup and view all the answers

What technology should be utilized to enhance safety during electrosurgery?

Tissue response generators Signup and view all the answers

What is the primary function of electrosurgical units (ESUs) during surgical procedures?

To cut and coagulate tissue Signup and view all the answers

How does direct current (DC) differ from alternating current (AC) in electrosurgery?

DC flows in one direction while AC flows back and forth Signup and view all the answers

In a monopolar electrosurgical system, where does the electrical energy flow begin?

From the generator through the active electrode Signup and view all the answers

What is the potential hazard associated with electrosurgery that must be managed carefully?

There is a risk of fire due to energy use Signup and view all the answers

What is the term used to describe heating the wire in electrocautery?

Coagulation burring Signup and view all the answers

Which of these is NOT a property of electricity relevant to electrosurgery?

Impulsiveness Signup and view all the answers

What must be ensured about the dispersive pads applied to the patient during electrosurgery?

They must be approved for direct contact with skin Signup and view all the answers

Which energy type is primarily used in the operating room for electrosurgery?

Alternating current (AC) Signup and view all the answers

What is the primary purpose of the dispersive electrode pad during electrosurgery?

To return the electrical energy safely to the generator. Signup and view all the answers

Which of the following is true regarding bipolar electrosurgery?

It does not require a dispersive electrode pad. Signup and view all the answers

What happens if the dispersive electrode pad is tented during surgery?

It increases the risk of patient burns. Signup and view all the answers

What is the function of a smoke evacuator in monopolar cautery?

To remove harmful plume created during tissue vaporization. Signup and view all the answers

Where should the dispersive monitoring pad be placed for optimal safety?

Over a well vascularized area such as the thigh. Signup and view all the answers

Which of the following buttons would a surgeon press to activate coagulation mode?

Blue button. Signup and view all the answers

What distinguishes capacitive pads from dispersive monitoring pads?

Capacitive pads are large pads placed on the OR table. Signup and view all the answers

What mode is activated by pressing the yellow button?

Cutting mode. Signup and view all the answers

What is a primary advantage of using capacitive pads during endoscopic surgery?

They eliminate the risk of tenting and burns. Signup and view all the answers

Which of the following best describes insulation failure in endoscopic instruments?

Exposed parts allow electrical current to escape. Signup and view all the answers

What is the purpose of the foot pedal during electrosurgery?

To activate the energy without hand contact. Signup and view all the answers

Capacitive coupling during endoscopic procedures can lead to what consequence?

Inadvertent current transfer to surrounding tissues. Signup and view all the answers

Why are hybrid instruments avoided during endoscopy?

They may increase the risk of capacitive coupling. Signup and view all the answers

What role does argon gas play in argon-enhanced electrosurgery?

Improves the effectiveness of the electrosurgical current. Signup and view all the answers

When does direct coupling occur during endoscopic surgery?

When an active electrode touches a non-insulated metal instrument. Signup and view all the answers

What maintenance strategy can help prevent insulation failure in endoscopic instruments?

Routine maintenance and care of instruments. Signup and view all the answers

What is one benefit of using electro thermal sealing devices?

Rapid coagulation of diffuse bleeding Signup and view all the answers

What is a potential risk when using electro thermal sealing devices in combination with MIS laparoscopic surgery?

Gas embolism due to over inflation Signup and view all the answers

Which action is recommended for scrub personnel when using electro thermal sealing devices?

Keep active electrode blades clean of tissue buildup Signup and view all the answers

What should be checked before applying pre-gelled patient pads?

Expiry date of the pads Signup and view all the answers

Which of the following should not be done according to the scrub role?

Using active electrodes in oxygen-rich areas Signup and view all the answers

What is a critical equipment check before operational use of electro thermal sealing devices?

Cables should be free of cracks Signup and view all the answers

Which of the following best describes a benefit of decreased penetration by electrical energy?

Less damage to surrounding tissues Signup and view all the answers

What is the recommended action for circulating personnel after placing the dispersive pad?

Monitor for any fluid spills Signup and view all the answers

Study Notes

Electrosurgery Overview

Electrosurgery utilizes electrical energy to cut and coagulate tissues during surgical procedures.
Electrocautery refers to the use of direct current (DC) to produce localized heat for coagulation.

Types of Electrosurgery

Monopolar Electrosurgery:
- Involves electrical flow from the generator through an active electrode to the patient.
- Requires a dispersive electrode (PAD) to return energy and prevent burns.
- The PAD should be placed on well-vascularized areas, avoiding excessive hair or bony prominences.
- Two activation modes: Blue for coagulation, Yellow for cutting.
- Smoke evacuators are necessary to remove harmful vapors during use.
Bipolar Electrosurgery:
- Uses low-power settings for coagulation without requiring a PAD.
- Energy flows between prongs of forceps, eliminating body involvement in the circuit.

Properties of Electricity

Current: Flow of electricity, measured in amps.
Voltage: Force moving electrons, measured in volts.
Impedance: Resistance to current flow, measured in ohms.
Types of Current:
- Direct Current (DC): Flows in one direction, causing tissue coagulation upon contact.
- Alternating Current (AC): Flows back and forth, used in electrosurgical devices.

Patient Return Electrode Pads

Dispersive Monitoring Pads: One-time use pads placed on the patient to prevent burns.
Capacitive Pads: Reusable and larger pads placed under the patient, reducing the risk of tissue damage.

Endoscopic Surgery Applications

Uses both monopolar and bipolar methods without hand activation buttons, requiring foot pedals.
Risks include insulation failure, direct coupling, and capacitive coupling, which can harm surrounding tissue.

Argon Enhanced Electrosurgery

Combines argon gas with electrosurgical energy to enhance coagulation efficacy.
Benefits include reduced blood loss, non-contact coagulation, and minimized surgical plume.

Safety Standards and Recommendations

ORNAC standards dictate proper placement and monitoring of dispersive pads.
Inspect active electrodes and cords for damage prior to use.
Activate tools at the lowest power settings and avoid prolonged activation.
Use bipolar electrosurgery when feasible to reduce patient risks.

Common Complications to Avoid

Frequent inspection of insulation to prevent burns.
Avoid activation in a closed circuit or near other instruments.
Prefer all-metal cannula systems to reduce hybrid coupling issues.

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Description

Test your knowledge on Electrosurgery through this Module 5 quiz. Explore key concepts, standard practices, and the role of devices like Ligasure in the surgical setting. Prepare to understand the crucial differences between electrosurgery and electrocautery.