Precautions In Patient Preparation - ConMed Sabre 2400 Operators & Service Manual

1.1.2 Precautions in Patient Preparation

• Electrosurgery should NEVER be performed
in the presence of flammable anesthetics, flam-
mable prep solutions, or in oxygen-enriched
environments. The risk of igniting flammable
gases or other materials is inherent in electrosur-
gery and cannot be eliminated by device design.
Precautions must be taken to restrict flammable
materials and substances from the electrosurgical
site, whether they are present in the form of an
anesthetic or skin preparation agent, or are pro-
duced by natural processes within body cavities,
or originate in surgical drapes or other materials.
There is a risk of pooling of flammable solutions
in body depressions such as the umbilicus and in
body cavities, such as the vagina. Any excess fluid
pooled in these areas should be removed before
the equipment is used. Due to the danger of igni-
tion of endogenous gases, the bowel should be
purged and filled with non-flammable gas prior to
abdominal surgery.
• This unit is equipped with the Aspen Return
Monitor (A.R.M.) which verifies that the return
electrode cable is unbroken and connected to the
return electrode and to the electrosurgical unit
when in Single Pad mode. It DOES NOT verify
that a single pad return electrode is in contact
with the patient. When in Dual Pad mode, the
A.R.M. confirms that the total resistance is in
the expected range. Do not depend solely on
the Resistance Indicator in the Dual Pad mode.
Proper application and visual inspection are
required for safe operation.
• The use and proper placement of a return elec-
trode is a key element in the safe and effective use
of electrosurgery in monopolar procedures, par-
ticularly in the prevention of burns. Follow direc-
tions and recommended practices for the prepara-
tion, placement, use, surveillance, and removal
of any return electrode supplied for use with this
electrosurgical unit.
• Apply the return electrode to a clean-shaven
surface of the patient that is thoroughly clean and
dry. Avoid placement on scar tissue, bony promi-
nences or other areas where pressure points on
small areas might develop.
• Because of the risk of burns, needles should
never be used as return electrodes for electrosur-
gery. Return electrodes should be placed such that
as much of their conductive area as possible is in
firm contact with an area of the patients' body
that has a good blood supply and as close to the
operative site as is practical. Adhesive-type return
electrodes should be reliably attached with their
entire area in contact with the patients' body.
• In general, electrosurgical current paths should
be as short as possible and should run either lon-
gitudinally or in a diagonal direction to the body,
not laterally and under no circumstances lateral to
the thorax.
• Electrodes and probes of monitoring, stimulat-
ing, and imaging devices can provide paths for
high frequency currents even if they are battery
powered, insulated, or isolated at 60 Hz. The
risk of burns can be reduced but not eliminated
by placing the electrodes of probes as far away
as possible from the electrosurgical site and the
return electrode. Protective impedances incorpo-
rated in the monitoring leads may further reduce
the risk of these burns. Needles should not be
used as monitoring electrodes during electrosurgi-
cal procedures.
• The active electrode should not be used in the
vicinity of electrocardiograph electrodes.
• Heat applied by thermal blankets or other
sources is cumulative with the heat produced at
the return electrode (caused by electrosurgical
currents). Risk of a patient injury may be mini-
mized by choosing a dispersive electrode site that
is remote from other heat sources.
• When using injection cannulas as electrocar-
diograph electrodes, the metal cone must not be
placed on the skin; this also applies to the leads to
monitoring instruments.
• During the use of this RF isolated output unit,
the patient should not be allowed to come in
contact with metal parts that are grounded or
other conductive surfaces that have an appreciable
capacitance to ground. This will minimize the
possibility of localized burns resulting from stray
electrosurgical currents to the ground.
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