What’s Your Energy IQ? Safe Use of Energy-based Devices During MIS Procedures

Brenda C. Ulmer, RN, MN, CNOR, Perioperative Nurse Educator

Surgical energy – does the array of surgical energy devices available to surgeons today sometimes seem shrouded in mystery and complexity? Gone are the days when the primary hemostatic devices were sutures, the “bovie” or the bipolar. From radiofrequency generators to ultrasonics, microwave and radiofrequency ablation, the possibility of methods to dissect tissue and provide hemostasis seem endless. Do you have questions about electromagnetic interference, patient return electrodes, pacemakers and implantable electronic devices? Do you ever wonder if perioperative team members have the skills and knowledge to use the devices safely and do no harm? Would you be surprised to learn that as part of a postgraduate continuing medical education course, 48 experienced members of Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) took an energy exam, and out of 11 answers, just 6.5 (59%) were correct. Fully one-third of the test takers did not know how to correctly handle a fire on a patient, 31% did not know which device was least likely to interfere with a pacemaker, and 13% did not know that thermal injury can extend beyond the jaws of a bipolar instrument. What is your energy IQ? The safe use of energy-based devices is essential to prevent patient injury during surgery and minimally invasive procedures.

Brenda C. Ulmer is a perioperative nurse educator with expert knowledge of energy-based devices including fire safety and the hazards of surgical smoke. Ulmer’s work history includes global director, professional education for Covidien energy-based devices, director of surgical services at Northlake Regional Medical Center in Atlanta, Georgia, as well as staff and charge positions at Emory University Hospital in Atlanta.

A long-term active member of AORN, Ulmer served three terms on the national board of directors, and as national president 2000-2001. Her current committee assignment is AORN representative to SAGES fundamental use of energy in surgery committee (FUSE). Ulmer is an inaugural board of directors’ member on the International Council on Surgical Plume (ICSP), a nonprofit organization dedicated to collaborative efforts focused on the evacuation and filtration of surgical plume.

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