Energy-Generating Devices

Clinical answers to frequently asked questions about the safe use of energy devices.
  • Can the patient's jewelry be taped over instead of being removed?

    Jewelry should be removed when it is in the pathway of the current between the active and passive electrode. The application of tape or an adhesive bandage over jewelry will only hold the jewelry in place; tape does not provide the insulation necessary to prevent a burn. Jewelry may not need to be removed if it is not in the pathway of the current and does not have an impact on the patient from an infection control or positioning aspect.

    Resource:

    • Guideline for safe use of energy devices. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated June 27, 2016

  • Do we need to have a person dedicated to running the laser or can the RN circulator run the laser?

    For every procedure that involves the use of a laser there needs to be a RN circulator, laser operator, and the laser user. There is one exception to this and that is the case where the laser user is able to operate the laser console. The laser user is the person who controls the hand piece. The laser operator is the person who turns the laser on and off from the console. The laser operator does not need to be a RN, but must be competent in operating the laser being used.

    Resource:

    • Guideline for safe use of energy devices. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated June 27, 2016

  • The grounding pad was partially removed by accident. Can I reapply it and stick it on with tape?

    In this situation a new dispersive electrode (aka, return electrode, grounding pad) should be applied. The electrode loses its effectiveness when the stickiness is lost, which occurs with removal, and it should not be reapplied with tape.

    Resource:

    • Guideline for safe use of energy devices. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated June 27, 2016

  • I have seen electrosurgery, electrocautery, and diathermy used interchangeably. Do they mean the same thing?

    These terms are used interchangeably in practice, although AORN uses them to describe different modalities for the delivery of energy.

    Electrosurgery is composed of two different energy delivery modalities (ie, monopolar and bipolar). During the use of monopolar electrosurgery, the current travels from the active electrode to the dispersive electrode through the patient. In contrast, the current only travels through the tissue that is between the tips of the bipolar device.

    In the electrocautery device, the current travels from the positive to the negative side through a loop of wire. The wire becomes hot and this provides the temperature necessary for coagulation and cutting of the tissue. The electrocautery device usually receives the current from a battery.

    Diathermy is frequently used by authors outside of the United States to refer to electrosurgery. In the United States, diathermy usually refers to the use of high frequency electromagnetic currents applied to the skin as a form of physical therapy (eg, short wave, ultrasound, and microwave).

    Resource:

    • Guideline for safe use of energy devices. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated June 27, 2016

  • Do I need to place a magnet on every pacemaker to deactivate it before use of electrosurgery?

    Magnet deactivation is not indicated for every pacemaker, because different types and brands of pacemakers may react differently. In fact, the response of the same brand and type of pacemaker to electrosurgery may vary depending on the age of the generator. Before using a magnet, the perioperative team should consult with the team who manages the pacemaker to determine the best interventions to take to prevent malfunctioning of the pacemaker.

    Resource:

    • Guideline for safe use of energy devices. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc.

    Updated June 27, 2016