March 1, 2007 | Health System Risk Management
Electrosurgery is commonly used in the operating room (OR) and elsewhere to cut soft tissue, control bleeding, and perform tissue ablation. Although electrosurgery is a well-established technology in the healthcare industry (i.e., it is used in about 80% of all surgical procedures1), it requires medical staff to strictly adhere to important preventive measures to protect patients and staff against inherent risks (e.g., patient burns). As one surgeon who presented during ECRI's March 2005 audio conference* on the topic said, electrosurgical technology "is becoming very, very sophisticated. The more complex it gets, the more things that can go wrong, and the more you can get yourself in trouble if you're not keeping abreast of new technologies."2 For example, staff may not be aware of the challenges and risks presented during laparoscopic monopolar electrosurgery and use of newer techniques that require continuous application of high current for long durations.
* Recordings on CD-ROM or audiocassette and course materials from the "Electrosurgery and Patient Safety: Critical Measures for Minimizing Risk" audio conference are available for purchase from ECRI. For more information, contact ECRI at (610) 825-6000, ext. 5891, or by e-mail at firstname.lastname@example.org.
On the other hand, some evidence suggests that the use of technology and adherence to safety procedures has contributed to a reduction in the volume of accounts of conventional electrosurgery-related injuries. For instance, ECRI has seen a decline in the number of reports of electrosurgical burns it receives, from 50 to 100 reports per month in the 1970s to perhaps 1 or 2 reports per month at present. This trend is also apparent in hospital and physician liability claims, as discussed later in this Risk Analysis. But regardless of incidence, the inherent risks of all types of electrosurgery, particularly user technique factors, need to be...