Used in a wide variety of surgeries, electrosurgical procedures are designed to assist in surgical cutting or to specifically control bleeding that is caused by coagulation at the surgical site.
Like any surgical procedure there are defined safety guidelines that must be followed to ensure the patient's electrosurgical procedure is both effective and completely safe. Patients with pacemakers, medical devices implanted to regulate the beating of the heart, require an additional set of safety precautions. Surgeons and anesthesiologists need to prepare and plan for the procedure to make sure the surgery is specifically tailored to the needs of a patient with a pacemaker.
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Electrosurgery Guidelines Specific for Patients with a Pacemaker:
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The first step should ALWAYS be to contact the manufacturer of the pacemaker and see if they have any specific requirements regarding electrosurgery.
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Ensure that the grounding pad is placed as far away as possible from both the pacemaker unit and its associated wires.
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The defined path from the electrosurgical tip to the grounding pad should not cross the circuit of the pacemaker.
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Since the noise of the electrosurgical procedure can potentially turn off or interfere with the pacing of the pacemaker, the anesthesiologist should be prepared to reset the pacemaker at any point to its asynchronous mode. This interference is due to capacitive coupling and can result in no pacing, a complete heart block, or potential severe tachycardia.
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During all electrosurgical procedures that involve a patient with a pacemaker, the pharmacologic pacer Isoproterenol should be available to the anesthesiologist.
Bovie Medical is committed to safe and effective electrosurgery and has been both a pioneer and leader in the field. Download our complimenary ebook Understanding Electrosurgery, which aims to introduce electrosurgery to providers and be a reminder and refresher to those already practicing electrosurgical procedures.
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Photo courtesy of Spirit-Fire
