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SURGICAL MODALITIES

SURGICAL MODALITIES. EL PASO COMMUNITY COLLEGE SURGICAL TECHNOLOGY PROGRAM MARGARET M. RODRIGUEZ, INSTRUCTOR. UNIT TITLES. ELECTRICITY, ELECTROSURGERY AND FIRE SAFETY IONIZING AND NON-IONIZING RADIATION ULTRASONIC AND HYDRODISSECTION DEVICES ENDOSCOPY/MINIMALLY INVASIVE SURGERY.

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SURGICAL MODALITIES

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  1. SURGICAL MODALITIES EL PASO COMMUNITY COLLEGE SURGICAL TECHNOLOGY PROGRAM MARGARET M. RODRIGUEZ, INSTRUCTOR

  2. UNIT TITLES • ELECTRICITY, ELECTROSURGERY AND FIRE SAFETY • IONIZING AND NON-IONIZING RADIATION • ULTRASONIC AND HYDRODISSECTION DEVICES • ENDOSCOPY/MINIMALLY INVASIVE SURGERY

  3. UNIT TITLES • MICROSCOPES AND MICROSURGERY • ROBOTICS AND GUIDED IMAGERY

  4. I. ELECTRICITY, ELECTROSURGERY AND FIRE SAFETY GLOSSARY OF TERMS ELECTRICITY – a fundamental entity of nature usually used as electric current

  5. CONDUCTOR • Any substance, medium, or material that allows the transmission of electricity (flow of free electrons) Examples: metals, carbon, salt water, humans

  6. INSULATOR • A medium that does not allow the transmission of electricity by inhibiting the flow of electrons. • A non-conductive material such as rubber, glass, porcelain, or wood.

  7. ELECTRICAL CHARGE • ALL MATTER CONSISTS OF ATOMS • ATOMS ARE COMPOSED OF: • Protons – positively charged particles • Neutrons – particles with no charge, neutral • Electrons - negatively charged particles

  8. ELECTRICAL CHARGE • When electrons move from one atom to another, an imbalance occurs. • An atom which has lost electrons will carry a positive charge. • An atom which has gained electrons will carry a negative charge.

  9. ELECTRICAL CURRENT • THE MOVEMENT OF ELECTRONS THROUGH A CONDUCTOR Example: a light bulb illuminates because electrons move through the conductor of wires and metal base to the tungsten filament in the bulb. The filament heats up and brightens – producing light.

  10. ELECTRICAL CURRENT Current • The rate at which electricity flows. • Measured in amperes.

  11. TYPES OF ELECTRICITY • Alternating Current (AC) – a current that periodically reverses its direction of flow. • Power from external power plant • Direct Current (DC) – a current flowing in only one direction. • Battery power

  12. ELECTRICAL TERMS • PATH OF LEAST RESISTANCE - electricity or the flow of electrons will act like water and always seek a path from highest concentration to lower concentration via the easiest route.

  13. ELECTRICAL TERMS • CURRENT LEAKAGE - all electricity can leak causing the potential for shock.

  14. ELECTRICAL TERMS • Ampere – the practical unit of current strength. • The amount of current flowing in a circuit. The rate of flow. • Ohm – the unit of electrical resistance of a conductor • Measurement of the ability of a material to receive flow of electrons.

  15. ELECTRICAL TERMS • Volt – the unit of electromotive force that moves electrons through a material. It induces current to flow in one direction. • The higher the number of volts, the more direct the current • Voltage – the potential energy of electrons. Electromotive force of an electric current expressed in volts.

  16. ELECTRICAL TERMS • Resistance – the opposition to the passage of a current. impedes or restricts the flow of electrons • Measured in ohms

  17. ELECTRICAL TERMS • GENERATOR – creates a force or voltage and moves electrons from one point to another. • Like a plumbing system that utilizes a pump to create water pressure and move water from one place to another

  18. ELECTRICAL TERMS • CIRCUIT - A moving or traveling around. In electricity, the entire course traversed by an electric current. When complete, it is a closed circuit, when interrupted, it is a broken circuit.

  19. ELECTRICAL TERMS • POWER – the rate of the movement of electrons from point to point or current flow. • Power = amps or current x voltage • Power is measured in watts

  20. ELECTRICAL TERMS • LOAD – the device that uses the electricity to perform some type of function • The load can change the amount of energy delivered from the power source • Examples: surgical lamps, ESU, video monitors

  21. ELECTRICAL TERMS • SWITCH – a device used to open or close a circuit and controls the flow of electricity.

  22. ELECTRICAL TERMS • HOT WIRE – the wire that connects to the switch. • In polarized plugs, hot wire is smaller prong • Often the hot wire is colored red

  23. ELECTRICAL TERMS • NEUTRAL WIRE – serves as the pathway for the electrons to return to the energy source and completes the circuit. • In a polarized plug, it is the larger of the prongs • Wire is often colored green

  24. ELECTRICAL TERMS • GROUND – the connection of an electrical current or circuit with the earth through a conductor. Safely conveys any leaking electrons to alternate path to ground. • Ground wires are often colored black

  25. ELECTRICAL TERMS • Hertz – a unit of electromagnetic wave frequency, equal to one cycle of alternating current (AC). • Each cycle starts at zero – flows in the positive direction, changes to negative, then back to zero

  26. ELECTRICAL TERMS • FREQUENCY – the number of waves passing through a given point per one second. This is measured in hertz.

  27. TYPES OF ELECTRICITY • STATIC ELECTRICITY – caused by friction and accumulates on objects • When two static-bearing objects come in contact, the one bearing the higher potential discharges to the one with the lower potential creating SPARKS.

  28. STATIC ELECTRICITY • An electrostatic charge or spark between two objects can occur only when there is no pathway of conductivity between them; therefore the chief aim is to provide a manner of dissipating the static accumulation.

  29. STATIC ELECTRICITY • Common environmental hazard in the OR • Does not cause patient shock or burns • However, its production of an electrostatic spark is its main hazard because this provides a source of ignition for a fire.

  30. STATIC ELECTRICITY • Risks have diminished because explosive anesthetic agents are no longer used.

  31. STATIC ELECTRICITY • PREVENTATIVE MEASURES INCLUDE: • Good conductive floors prevent accumulation by providing a pathway of conductivity between persons and equipment coming in contact with the static electricity.

  32. STATIC ELECTRICITY • PREVENTATIVE MEASURES • Safe furniture is made of electrically-conductive materials or contact to the floor is made through electrically-conductive leg tips, casters, or wheels.

  33. STATIC ELECTRICITY • PREVENTATIVE MEASURES • Operating room floors are cleaned with materials that do not reduce conductivity.

  34. STATIC ELECTRICITY • PREVENTATIVE MEASURES • Avoid wool and synthetic fabrics that have not received anti-static treatment. • Use cotton blankets, towels, etc.

  35. STATIC ELECTRICITY • PREVENTATIVE MEASURES • Use special anti-static liners in trash and linen hampers and kick buckets.

  36. STATIC ELECTRICITY • PREVENTATIVE MEASURES • Maintain room humidity level at 50-60%

  37. STATIC ELECTRICITY • PREVENTATIVE MEASURES • Dissipate charges by frequently touching metal surfaces and avoid friction causing activities. • example: avoid movement around patient’s head, especially if his/her hair is uncovered.

  38. ELECTRICAL SHOCK • ELECTROCUTION – the most severe case of electrical shock, often lethal. • Occurs when a person becomes part of the circuit or closes the circuit.

  39. ELECTRICAL SHOCK • MACROSHOCK – requires a substantial voltage to drive electrons through a highly resistant skin path. • Can range from small tingling to electrocution • Due to things such as frayed electrical cords, spilling of liquids on generators, radio with no back covering, or removal of ground plug.

  40. ELECTRICAL SHOCK • MICROSHOCK – electrical shock below the level of sensation so can come from undetectable sources. • Requires only a small amount of current but must involve passage through the heart to cause damage. If so, can also be lethal. • Incidents usually arise from equipment failure, wet floors, ungrounded stretchers, or indwelling catheters/monitors, etc.

  41. ELECTRICAL HAZARDS

  42. PRECAUTIONS • INSPECT THE POWER CORD AND PLUG BEFORE EVERY USE

  43. PRECAUTIONS • DO NOT USE EQUIPMENT ON WHICH LIQUIDS HAVE BEEN SPILLED.

  44. PRECAUTIONS • NEVER STACK THINGS ON OR BEHIND ELECTRICAL EQUIPMENT WHICH MIGHT INTERFERE WITH PROPER VENTILLATION OF THE DEVICE.

  45. PRECAUTIONS • TWO-PRONG EXTENSION CORDS OR ADAPTORS SHOULD NOT BE USED IN THE OR.

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