Question about jewelry and ESU

[IsseyM]

Hello everyone,

I just started my AORN classroom training at my new job and i have a couple of questions.

I've noticed before surgery that some patients will have their rings taped. Now i read in my AORN outline on Electrosurgery that all jewelry should be removed because alternate pathway burns may occur. I heard from one of the nurses that wrapping tape around a ring prevents arcing. Is this true? Also what if a patient has metal hardware in their body? Is Bipolar always used? Or is electrosurgery not used at all?

[wildredhead]

do you have a copy of the waiver you could email to me? we are having this issue at our surgery center, and i want to protect the patients.

please pm me your email and i will send you my email address. (edited by dianah)

[wildredhead]

According to ValleyLab, they still recommend that ALL jewelry be removed.

[BethCNOR, BSN, RN]

Our Ethicon reps just presented an inservice to us on the use of "electosurgery" equipment. I learned a lot of things i didn't know and that I had some misconceptions based on my earlier training. The new cautery equipment out there use radiofrequency now, not true electric current. The old machines needed the pad to "ground" the patient. The pads today complete the cycle back to the machines, so it isn't grounding. They said with the new technology, the only time you need to be concerned about burns from jewelry is if the jewelry comes in contact with the metal on the OR table. Otherwise, no need to worry. Taping rings is to keep rings from falling off during surgery or to make sure settings don't fall out and get lost. Ask your cautery rep to give an inservice.

[Scrubby]

If a patient is having a thyroidectomy and they have a naval ring then it doesn't make sense to remove it. If they are having a laparotomy then yes I will because of the slight risk of a burn and also infection control. If the patient has a hip replacement then I place the diathermy plate on the opposite limb, if it's bilateral then we roll the patient and place it on their flank.

I have never seen a diathermy burn, but I have heard of one about ten years ago where a nurse placed the pad directly over bone. It wasn't a split pad either.

[SandraCVRN]

I'm with a couple of the others, I'm not worried about the burns, it's the swelling....