Warnings And/Or Precautions During Use; Adequate Use Of Patient Plate (Patient Return Electrode); Important Recommendations For Patient Plate Application; Warnings, Recommendations And Cautions In Surgeries - WEM SS-200E Manual De Utilización

4.3 – Warnings and/or precautions during use
Do not use this equipment or a part thereof for purposes for which it was not projected. Do not make
changes to the equipment
Never try to repair the equipment. Call the authorized technical assistance.
Do not pull strongly the output power cable.
The product may only be used or operated by a qualified professional (physician) or under his/her
supervision.
4.4 – Adequate use of patient plate (patient return electrode)
Before applying the plate to the patient, the expiration date should be checked in case of disposable plates.
The manual accompanying the plate should be checked to ensure the correct use of accessory.
In monopolar surgery, the return electrode (patient plate) is used to disperse the radiofrequency current
that comes out from the pencil, goes through the patient's body and returns to the electrosurgical unit, thus
closing the circuit. For this reason, the area of contact with the patient's skin must be adequate to maintain
the current density at sufficiently low levels to prevent temperature increases that could cause burns to the
patient.
The ideal would be that 100% current returned to the patient plate, which practically occurs when a bipolar
instrument is used. In monopolar electrosurgery, current not always returns to the patient plate because of
reactive effects of radiofrequency. However, it is possible to minimize the risks of burns caused by such
leakage currents by following the important recommendations listed below.
4.5 – Important recommendations for patient plate application

A neutral electrode, also known as patient plate, passive, return or dispersive electrode, should be
efficiently connected to all over its surface and the patient's body.
 Position the patient plate on a strongly vascularized muscular region. Avoid placing ECG electrodes and
cables on eschars, scars, osseous protuberances, and metallic prostheses. Do not place them where
fluid infiltration is likely to occur.
 Position the patient plate as close as possible to the surgery place.
 Position the ECG electrode or other small grounded contact points as far as possible from the space
between the surgery place and the patient plate to reduce the risk of burns in such points as a result of
current deviations. Never use ECG needle electrode during the surgical procedure. Use of monitoring
system containing devices to limit the high-frequency currents is recommended.
 Eliminate all bristles from the patient plate application place. Clean and dry the place.
 If you are using a stainless steel reusable patient plate, use "Electrocardiogram" gel, which is a
conductive gel. In such a case, observe the gel moisture condition during the surgical procedure. When
dried, gel assumes a high electric impedance – a very important consideration in long-duration surgical
procedures and long use of electrosurgical unit.
Note: do not use "ultrasound" gel in patient plates.
 If an adhesive patient plate is used, it is not necessary to add a conductive gel as the plate is already
provided with gel.
 Frequently check the conditions of the plate cable and if the patient plate is properly positioned on the
patient's body, which should be repeated whenever the patient's position is changed.
4.6 – Warnings, recommendations and cautions in surgeries
Electrosurgery has been safely used in a great number of surgical procedures. In addition, it is very
important that, before starting any procedure, the surgeon is familiar with medical literature, complications
and risks of electrosurgery in that surgical procedure.
4.6.1 – Warnings in surgeries
 Sparking and heat generation associated with electrosurgery constitute an ignition source for such
flammable materials as:
1. Flammable anesthetics or oxidizing gases, such as nitrous oxide (N2O) and oxygen, when used in
surgical procedures in thorax or head, unless such agents are evacuated by aspiration.
2. Flammable solutions likely to accumulate beneath the patient or depressions or cavities in his/her
body, such as umbilicus or vagina. All fluid accumulated in such areas should be eliminated before
the equipment is used.
WEM / SS-200E User Manual
Rev. 11
28