o Before activating any electrosurgical unit (ESU), electrocautery unit or laser, the tip must always be in plain view. The tip must not come into contact with any combustible materials. Deactivate the tip before it is removed from the surgical site. Following the use of any electrosurgical or electrocautery unit, laser or high intensity light source, the device should either be turned off or switched to a non-functioning stand-by mode. This will prevent any potential activation and/or resulting fire. Tips should be kept in a non-conductive holster when not in use. When possible, use hand-activated ESU’s to decrease the risk of an accidental discharge by another staff member. If a foot-activated ESU is used, it should be positioned as close as possible to the designated operator. Footswitches should never be located where they could be activated by mistake. Ensure that the activate electrode of the ESU is not activated or energized near a piece of metal that could conduct the charge and cause a fire.
o Every medical equipment electrode should be maintained as clean as possible. Any build-up on the electrodes due to tissue-cutting should be removed because it can lead to additional electrical resistance and heat build-up. Watch the location of the grounding electrode or plate. Poor locations for using a grounding electrode or plate are wet areas, hairy areas, and non-muscular areas of the body. Any electrical resistance within the electrodes from any source can cause arcing. Don’t insulate electrodes with anything other than fire-resistant materials.
o Electrosurgical/electrocautery units and lasers should be operated at the lowest possible output settings to accomplish the surgery.
o Use a laser-specific endotracheal tube when operating on the head, neck, lungs or other airway tissue. Inflate cuffed tube bladders with a tinted saline solution so that if the tube is damaged, a visual indicator will alert the surgical team of a possible airway fire.
o Before using a defibrillator in the surgical suite, ensure that the proper size paddles are available, that the site placement for the paddles is correct, and that proper contact is made prior to the discharge being delivered to the patient.