In this MRCS Part B scenario you are the surgical registrar. The anaesthetist for today’s list has some questions for you.
What are the complications of incorrect placement of the patient electrode and how can you minimise them?
The main complication of diathermy is a burn to the patient.
This can happen through operator error through contact with the skin, or through incorrect placement of the patient electrode. These can be minimised by careful technique, and by placing the patient electrode correctly on dry, shaven skin, away from bony prominences, with a good contact established.
Other risks with diathermy include interference with pacemaker function, ignition of volatile gases and liquids which might occasionally be used in theatre, and arcing of a spark via other metal surgical instruments so that a burn occurs at a site distant to the electrode.