Energy Generating Devices?

Question 1

What are energy generating devices used for?

Answer 1

To cut and coagulate during surgery
Ex monopolar

Instruments coated w/ insulation to prevent electricity from leaking
- any breaks can cause energy to escape and cause burns

Question 2

Safety practices for energy generating devices?

Answer 2

Power setting - lowest that achieves desired result

Foot pedal - controlled by surgeon

Conductive trocar - safe path for flow of current

Inspection - before, during and after

Scanning devices - ensure insulation not compromised

Question 3

What is Surgical smoke?

Answer 3

By product of energy generating devices
Ex lasers

Health hazard - carbonized tissue, blood, viruses and bacteria

Should be removed to protect pt and staff

Question 4

What happens if surgical smoke os absorbed by blood?

Answer 4

Decreased oxygen carrying capacity of RBCs

Question 5

What is robotic surgery?

Answer 5

Computer assisted
- electromechanical devices engineered to replicate surgeons movements

Benfits:
Precision
Flexability
Efficiency 
Safety

Question 6

What are components of robotic surgery and which is part of sterile field?

Answer 6

Surgeon console
- hand/foot controls

Vision cart

Patient cart
*sterile

Question 7

What is patient cart docking?

Answer 7

Moving robotic arm over the sterile field after being draped

Activated by a targeting button and laser beam

After docking do not move patient

Question 8

Risks of robotic surgery?

Answer 8

Insulation failures and capactive coupling injuries 
Insufflation injuries 
Fire risk 
Long procedures
Positioning injuries 
Having to convert to open 
Equipment failure

Question 9

Hybrid ORs?

Answer 9

Designed with numerous technologies
- CT, MRI, US, PET

Patient can stay in one location while multiple providers provide care

Question 10

MRI zones?

Answer 10

1 - uncontrolled space
2 - interface area between zone 1&3
3 - strictly controlled area containing control room
4 - restricted scanner room:
- warning signs
- MRI safe equipment
- 5 gauss line to represent area of danger

Question 11

Why should you be prepared to switch to open procedure during laproscopic?

Answer 11

Risk when trocar is inserted into peritoneum to cause injury

Always have supplied ready and counted

Question 12

Before cleaning endoscopes what should you do?

Answer 12

Disassemble multi part instruments, but keep together
Open ports/valves/ratchets
Rinse with COOL water

Question 13

Do endoscopes need to be sterilized?

Answer 13

Can be sterilized or high level disinfection

Semi critical items - high level

Critical items - sterilization
- come into contact with sterile tissue

Question 14

Direct vs capactive coupling?

Answer 14

Direct = transfer of electronical energy by direct physical contact

Capactive = displacement of electrical current