Patient “Grounding”

Abstract

Dispersive electrodes are often neglected or misused in electrosurgery. A dispersive electrode can increase electrosurgical safety and effectiveness. If misused, however, it can become the source of patient injury. The following article summarizes the proper use of dispersive electrodes and differentiates them from actual grounding.

Electrocoagulation and hazardous damage to a dental prosthesis

“…The most common adverse events seen with ECDs are attributed to electrical interference of pacemakers or to a shock or burn of the patient if contact is made with a grounded metal surface. [1][2][3] With the advances seen in other medical specialities, we might discover new danger zones in our daily practice. The anchoring of a dental prosthesis with a magnetic device has been practiced for 20 years in Switzerland.…”

Fire Hazards and Electrosurgery

“…Power settings and the accompanying heat and sparks can be minimized by using very small, delicate treatment electrodes 10 . For complex electrosurgical procedures, the risk of extraneous sparks is minimized by having the patient in adequate contact with a dispersive electrode 11 …”

Blood Vessel Coagulation for Incisional Surgery

“…If pinpoint electrocoagulation cannot be accomplished using Hyfrecator current conducted through a hemostatic clamp, it is a strong indication that too much tissue is being held within the clamp tips. In other words, a high‐output generator used at a high setting with a dispersive electrode will permit coagulation of large amounts of tissue and allow the surgeon to get by with sloppy electrocoagulation technique 8 …”