Bovie Aaron 1250 User Manual page 30

entirely. Consult the device manufacturer or hospital Cardiology Department for further information
when use of electrosurgical appliances is planned for patients with cardiac pacemakers or other
implantable devices.
If the patient has an Implantable Cardioverter Defibrillator (ICD), contact the ICD manufacturer
for instructions before performing an electrosurgical procedure. Electrosurgery may cause
multiple activation of ICDs.
Do not use electrosurgical equipment unless properly trained to use it in the specific procedure
being undertaken. Use by physicians without such training has resulted in serious, unintended
patient injury, including bowel perforation and unintended, irreversible tissue necrosis.
For surgical procedures where the high frequency current could flow through parts of the body
having a relatively small cross-sectional area, the use of bipolar techniques may be desirable to
avoid unwanted coagulation.
In some circumstances, potential exists for alternate site burns at points of skin contact
(e.g., between the arm and the side of the body). This occurs when electrosurgical current
seeks a path to the patient return electrode that includes the skin-to-skin contact point.
Current passing through small skin-to-skin contact points is concentrated and may cause
a burn. This is true for grounded, ground referenced, and isolated output generators.
When HF SURGICAL EQUIPMENT and physiological monitoring equipment are used simultane-
ously on the same PATIENT, any monitoring electrodes should be placed as far as possible from
the surgical electrodes. In all cases, monitoring systems incorporating HIGH FREQUENCY current
limiting devices are recommended.
To reduce the potential for alternate site burns, do one or more of the following:
• Avoid skin-to-skin contact points, such as fingers touching leg, when positioning the patient.
• Place 5 to 8 cm (2 to 3 in.) of dry gauze between contact points to ensure that contact does
not occur.
• Position the patient return electrode to provide a direct current route between the surgical
site and the return electrode which avoids skin-to-skin contact areas.
• In addition, place patient return electrodes according to the manufacturer's instructions.
Potential for alternate site burns increases if the return electrode is compromised. Bovie Medical
recommends the use of split patient return electrodes and Bovie Medical generators with a
contact quality monitoring system.
Do not wrap the accessory cords or patient return electrode cords around metal objects. This
may induce currents that could lead to shocks, fires, or injury to the patient or surgical team.
Minor neuromuscular stimulation is possible when arcs between the ACTIVE ELECTRODE and
tissue occur. The generator has been designed to minimize the possibility of neuromuscular
stimulation.
Accessories must be connected to the proper receptacle type. In particular, bipolar accessories
must be connected to the Bipolar Instrument output jack only. Improper connection may result in
inadvertent generator activation.
The use of flammable anesthetics or oxidizing gases such as nitrous oxide (N2O) and oxygen
should be avoided if a surgical procedure is carried out in the region of the thorax or the head,
unless these agents are sucked away.
Non-flammable agents should be used for cleaning and disinfection wherever possible.
Flammable agents used for cleaning or disinfecting, or as solvents of adhesives, should be
allowed to evaporate before the application if HF surgery. There is a risk of pooling flammable
solutions under the patient or in body depressions such as the umbilicus, and in body cavities
such as the vagina. Any fluids pooled in these areas should be mopped up before HF surgical
equipment is used. Attention should be called to the danger of ignition of endogenous gases.
Some materials, for example cotton, wool and gauze, when saturated with oxygen may be ignited
by sparks produced in Normal Use of the HF surgical equipment.
The generator is equipped with a return electrode sensing and contact quality monitoring system
(NEM), which monitors the quality of the patient return electrode connection. When a correctly
functioning single plate return electrode is connected to the generator, the NEM verifies the con-
nections between the generator and the single return electrode. It DOES NOT verify that a single
User's Guide • Aaron 1250 ™ 4-3