Background: Today, electrosurgical units are an indispensable part of surgeries. Yet, inappropriate application of this equipment can result in dire consequences for both the patient and the surgical team. Objectives: The present study aimed at developing the psychometric properties of a checklist to evaluate the application of electrosurgery units by operating room personnel. Methods: The present methodological study was performed in two stages: first, the items of the checklist were developed based on a literature review and search in relevant websites; and second, the psychometric properties of the checklist were measured using the methods to evaluate face, content, and construct validities. The reliability was measured through an assessment of the internal consistency of the checklist, based on the degree of inter-rater agreement. To assess construct validity, the researchers compared known groups; 40 surgeries were observed in two university hospitals in the intervention and control groups. Results: The content validity index (CVI) of all the items was over 0.79. The average CVI (S-CVI/Ave) of the checklist with 32 items was 0.97. The results of the Wilcoxon test showed that the posttest performance scores of the personnel in the intervention group were significantly higher than their pretest scores (P value = 0.005). The internal consistency (the Kuder-Richardson coefficient) of the checklist was 0.66. Conclusions: Due to the great importance of appropriate application of electrosurgery units, a reliable instrument is needed to assess personnel's performance in this area. The results of the current study showed that the present instrument is sufficiently valid and reliable to evaluate the application of electrosurgical units by the operating room personnel.
The patient was a 32-year-old woman who presented with infertility secondary to uterine didelphys. Hysteroscopic metroplasty was chosen as the corrective surgical procedure for this anatomical defect. During the surgical repair, the patient developed a massive air embolism (MAE) leading to hypotension, arrhythmia, and cardiogenic shock. Resuscitation was started by placing the patient in the right-side up position, and emplacement of central venous catheter, but it was unsuccessful. The decision was then made to bypass the patient's cardiopulmonary system to effectively treat the MAE. Cannulation was done via femoral vein and artery. During cardiopulmonary bypass (CPB), the MAE was quickly eliminated, oxygen saturation was normalized, and the patient was hemodynamically stabilized. The surgical repair was successfully completed and the patient was decannulated and recovered without any incident.
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