Module 10 Part 2

Question 1

Electrical equipment in the OR must be _______ through a ______ wire

Answer 1

Grounded

Third

Question 2

T/ F
There is no direct electrical connection between the power supplied by the utility company on the primary side and the power induced by the isolation transformer on the secondary side

Answer 2

True

Question 3

T/F

A person in contact with only one of the two lines in an IPS system will receive a shock by completing the circuit

Answer 3

False, The person must be in contact with both lines 1 and 2 to complete the circuit. the ground is not part of the circuit

Question 4

T/F
A faulty piece of equipment plugged into an isolated power system, may have a partial short circuit, but will not usually trip the circuit breaker

Answer 4

True

Question 5

This type of device continuously monitors the integrity of an isolated power system

Answer 5

Line isolation monitor

Question 6

A line isolation monitor measures the ______ to the ground on each side of the isolated power system

Answer 6

Impedance

Question 7

Faulty equipment plugged into an IPS can change the system to a ______ system

Answer 7

Grounded

Question 8

T/F 
If faulty equipment is plugged into the IPS it will continue to function normally but the LIM will alert that power is no longer ungrounded

Answer 8

True

Question 9

What should you do if the line isolation monitor alarms?

Answer 9

Check the line isolation monitor reading and if possible unplug the last device that was plugged in

Question 10

LIM Meter indicates how much current would flow in the event of a first fault and it’s set to alarm at _____

Answer 10

2-5 mA

Question 11

In the event of a second fault with an isolated power system what can result?

Answer 11

Shock

Question 12

What does GFCI stand for?

Answer 12

Ground fault circuit interrupter

Question 13

How does a GFCI work?

Answer 13

It does not measure current but will trip and cut power when leakage current to ground exceeds a predetermined value in a grounded system-

Aka it monitors the difference in flow between two sides of the circuit and if a difference is detected the powers immediately interrupted

Question 14

How do you prevent a second fault (the dangerous fault)?

Answer 14

Address the first fault by unplugging devices until you find the damaged equipment or issue that needs to be addressed

Question 15

What does the first fault mean?

Answer 15

The first fault means that the line isolation monitor has detected that isolation from the ground has been degraded beyond a predetermined limit, a second fault may cause a shock

Question 16

T/F

All electrical equipment should be tested periodically by trained personnel

Answer 16

True

Question 17

If electrocautery is required, patient must have a properly placed ______

Answer 17

Dispersive pad

Question 18

T/F

In the OR electrical equipment should be grounded (three pronged plug)

Answer 18

True

Question 19

T/F

Do not use damage freight or crushed plug wires

Answer 19

True

Question 20

T/F

If the LIM alarms immediately unplug the last electrical device

Answer 20

True

Question 21

________ Involves relatively large amounts of current applied to the surface of the body. The current is conducted through all the tissues in proportion to their conductivity and area in a plane perpendicular to the current

Answer 21

Macro shock

Question 22

T/F

Stray current from the electrosurgery unit can cause microshock

Answer 22

True

Question 23

What factors cause a patient to be more susceptible/higher risk for microshock

Answer 23

CVP or PA catheter that is Saline filled
Pacing wires
Any direct external connection to the heart that may conduct a large current density directly to the myocardial tissue

Question 24

Name the two types of ESU units

Answer 24

Monopolar and bipolar

Question 25

How does an ESU work?

Answer 25

ESU operates by generating very high frequency currents (from 500,000 to 1,000,000 Hz) which passed through tissue. Heat is created by the resistance of tissue to current flow

Question 26

Name two uses for The ESU device 

Answer 26

Therapeutic cut | Coagulation

Question 27

How does a monopolar ESU safely direct energy?

Answer 27

Patient must have a properly place dispersive electrode of large surface area that returned the energy safely to the ESU device

Question 28

If the dispersive pad for a monopolar ESU device is applied incorrectly, has damage wires, is broken, what can result?

Answer 28

High frequency current will seek an alternate pathway, such as ekg leads or temp probes, which have a lower surface area and can result in serious burns at these alternate sites or the ESU return site

Question 29

Name three important factors for proper application of a dispersive return pad with ESU use

Answer 29

Ensure intact equipment- return wire instact and gel pad is not dried out Place dispersive pad as close as possible to surgical site EKG pads must be placed as far as possible from surgical site to avoid alternate route

Question 30

T/F | Pools of flammable prep solution such as alcohol or acetone can ignite when the ESU is used

Answer 30

True

Question 31

Name the precautions to be used when a monopolar ESU is used with a demand pace maker

Answer 31

The return electrode should be located below the thorax Preparation for treating potential arrhythmia should be available- including a magnet to convert pacemaker to a fixed rate, a defibrillator, and an external pacemaker It is best to keep the pacemaker out of the path between the surgical site and the dispersal plate

Question 32

How is a bipolar ESU different than a monopolar ESU?

Answer 32

With a bipolar ESU the current passes between the two edges of the forceps rather than the forceps tip and the dispersive pad

Question 33

T/F | Current in a bipolar ESU flows through only the tissue at the site of surgery and the return pad is not necessary

Answer 33

True

Question 34

T/F | Bipolar ESU generates less power than monopolar ESU

Answer 34

True

Question 35

Which ESU device is preferable in the presence of pacemakers, AICDs, deep brain stimulation, and spinal cord stimulation?

Answer 35

Bipolar ESU

Question 36

T/F Healthcare facilities are required to have emergency power, typically electrical generators, the Sellitti is required to test every Three years for four continuous hours, ideally during peak usage of the system

Answer 36

True

Question 37

T/F | Modern anesthesia machines do not depend on electrical power and function when electricity is lost

Answer 37

False Modern anesthesia workstations are heavily dependent electrical power but do you have a battery backup system that can power the workstation for 1 to 2 hours

Question 38

T/F Without power only basic functions on an anesthesia workstation are available including emergency oxygen and conventional vaporizer to provide inhalational anesthesia

Answer 38

True

Question 39

Which special vaporizer cannot deliver anesthetic without power

Answer 39

The Desflurane tech six and many newer electronic vaporizers cannot deliver anesthetic without electrical power

Question 40

What are the steps to take in an emergency power failure when your anesthesia station no longer has power?

Answer 40

Convert to total IV anesthesia, use IV pump if batteries OK or administer IV and titrate to affect Call for an extra O2 tank locate Ambu bag in case ventilator battery depleted May be able to use transport monitor battery or may require manual BP and stethoscope  Maintain communication with surgeon that life-sustaining equipment is exhausted and surgery needs to end as soon as possible

Question 41

What measures did ORs institute to prevent static electricity causing fires

Answer 41

Anti-static footwear Nonconducting wheels on carts OR humidity kept > 50%

Question 42

Common term used in naming an ESU?

Answer 42

Bovie