Best Practices and Common Mistakes in Using Electrosurgical Units: A Guide by Nazmed SMS Sdn Bhd

Electrosurgical units (ESUs) are essential tools in modern surgical practices. They are used to cut, coagulate, or vaporize tissue with the help of high-frequency electrical currents. While they play a crucial role in enhancing surgical efficiency and precision, improper use or neglect of safety standards can lead to serious complications. At Nazmed SMS Sdn Bhd, we specialize in manufacturing high-quality medical instruments and believe in promoting safe practices for medical professionals. In this article, we’ll explore the best practices and common mistakes in using electrosurgical units to ensure safe and effective outcomes in the operating room.

Best Practices for Using Electrosurgical Units

1. Pre-Use Inspection and Maintenance Before any electrosurgical unit (ESU) is used, it’s crucial to inspect it for any signs of wear or malfunction. Regular maintenance of the device ensures that all components are functioning properly. Inspect the electrodes, cables, and grounding pads for signs of damage, and confirm that all connections are secure. Periodic servicing and calibration of the equipment should be done by qualified professionals to ensure that the ESU performs optimally.
2. Understanding the Different Modes of Operation Electrosurgical units typically offer various modes, such as cut, coagulation, and blended modes. Each mode serves a specific purpose during surgery:
   • Cut Mode: Used for precise incisions in the tissue with minimal blood loss.
   • Coagulation Mode: Used to stop bleeding by coagulating blood vessels.
   • Blended Mode: A combination of both cutting and coagulation for more controlled procedures.
3. Medical practitioners should be well-versed in these modes and select the appropriate setting based on the surgical requirements to maximize efficiency and minimize tissue damage.
4. Proper Placement of the Grounding Pad The grounding pad is a critical safety feature that helps complete the electrical circuit during electrosurgery. It is vital to place the grounding pad correctly on the patient’s body, ensuring full contact with the skin and avoiding any folds or air gaps. The pad should be positioned on a large muscle area, away from bony prominences or surgical sites. Proper placement helps prevent burns or injury to the patient from electrical malfunctions.
5. Adhering to Recommended Power Settings ESUs are powerful tools that require careful control of power output. It is essential to adjust the power settings based on the surgical procedure, the tissue type, and the intended effects. Surgeons should start at lower power settings and increase gradually, if necessary, while ensuring that the tissue is not overexposed to electrical current. Proper power control helps to reduce the risk of thermal injury to surrounding tissues.
6. Use of Proper Electrode Type Electrosurgical instruments come with different types of electrodes, such as needle, ball, and loop electrodes, each serving a unique function. Using the appropriate electrode type for the procedure is vital for achieving the desired outcome. For example, needle electrodes are ideal for cutting, while ball electrodes are more suitable for coagulation. Selecting the correct electrode minimizes the risk of unnecessary damage and ensures optimal precision.
7. Continuous Monitoring The surgical team should continuously monitor the patient during the procedure, checking for any signs of burns or electrical faults. The ESU should be used in conjunction with a well-trained team that can recognize complications early. Monitoring helps in ensuring the patient’s safety and allows for swift intervention if any issues arise.

Common Mistakes in Using Electrosurgical Units

1. Failure to Maintain or Inspect the Equipment One of the most common mistakes in using ESUs is neglecting regular maintenance and inspection of the equipment. Broken cables, faulty electrodes, or damaged grounding pads can significantly affect the performance of the ESU and lead to complications, including burns, electrical shocks, or surgical delays. Always ensure the equipment is in top condition before use.
2. Incorrect Placement of the Grounding Pad Incorrect placement of the grounding pad is a frequent error that can lead to patient burns, excessive tissue damage, or equipment malfunction. The grounding pad should be placed on a clean, dry area of the patient’s body and should be firmly adhered to ensure proper electrical contact. Placing it over bony prominences or in areas where skin integrity is compromised increases the risk of patient injury.
3. Overheating of the Tissue Another common mistake is using excessive power or keeping the electrode in contact with the tissue for too long. This can cause overheating, which results in unnecessary tissue damage and patient harm. It’s essential to constantly monitor the ESU settings and tissue response, ensuring that the right amount of heat is applied for the desired effect without causing excessive thermal injury.
4. Inappropriate Mode Selection Choosing the wrong mode for a particular procedure can lead to ineffective results or damage to the tissue. For instance, using coagulation mode when cutting is required can cause the tissue to become charred and difficult to work with. Surgeons should always be familiar with the ESU’s different settings and select the one that best matches the procedure’s goals.
5. Inadequate Training One of the most significant factors contributing to errors in electrosurgery is insufficient training and knowledge of how the unit works. Surgeons, nurses, and support staff must undergo regular training to stay current with the equipment and its functions. Inadequate training can lead to mistakes like improper electrode usage, incorrect power settings, or mishandling of the equipment.
6. Lack of Sterility Electrosurgical units and their accessories must be handled with utmost care to maintain sterility. Contaminating electrodes or cables with non-sterile instruments can introduce infections during surgery. Proper sterilization protocols should always be followed for all ESU components to ensure patient safety.

Conclusion

Electrosurgical units are indispensable tools in modern surgery, offering precision, efficiency, and safety when used correctly. By following best practices such as regular maintenance, proper electrode selection, and careful monitoring, healthcare professionals can maximize the benefits of ESUs and minimize the risks. At Nazmed SMS Malaysia, we are committed to promoting safety and excellence in surgical procedures. We understand the importance of high-quality, reliable medical instruments, and we urge medical practitioners to stay informed and continuously improve their skills to ensure the best outcomes for their patients.

As technology advances, so too should our understanding and application of these tools. The combination of precision, training, and safety will pave the way for successful surgical outcomes, making a world of difference for patients and practitioners alike.