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Diathermy; a two pronged attack. In this assignment, the responsibilities of the operating department practitioner when dealing with diathermy will be analysed and reflected upon, as well as how this relates to aspects of best practice in patient care. I

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Module 2 Diathermy; A two Pronged attack 04/10/D001 Student number: 099028691 Words 2200 Contents Introduction 3 Background 4 Minimizing the risk 5 Accountability 7 Continued education 8 The smoke plume 8 Conclusion 10 References 12 Introduction In this assignment, the responsibilities of the operating department practitioner when dealing with diathermy will be analysed and reflected upon, as well as how this relates to aspects of best practice in patient care. I will also be concentrating on the health risks associated with diathermy and how these might be managed, drawing upon my own experiences in theatre as well as the legal, ethical and professional guidelines already in place. The main question I will endeavor to answer is: are these guidelines consistently followed? And if not, why is this? Cunnington (2006) describes the essence of electrosurgical intervention as harnessing something dangerous to bring about benefit, so understanding the hazards related to diathermy is critical in implementing adequate protective measures for both patients and perioperative personnel. Background There are two types of diathermy, 'monopolar' and 'bipolar'. The National Association of Theatre Nurses (NATN 1998) describes 'monopolar' as the passage of a high frequency current which passes through the patient from the diathermy forceps to the diathermy plate electrode. In bipolar diathermy, the current passes between the two points of the forceps so the active and return electrodes have a much shorter journey. ...read more.


For example, Wicker (1992) explains how accidents can occur due to staff not being duly attentive. He explains that activating the forceps before they are touching anything will flood the room with radio frequency current. These radio waves are trying to return to the diathermy pad electrode but may take a detour via another object or quite possibly, a person. If they happen to be touching a towel clip which has pierced the drape and is in contact with the patient's skin, there is the potential for a burn at the point of contact, as the current takes its journey back to the Diathermy plate electrode. Accountability There is shared responsibility with the surgeon; often a grey area in theatre. Fulbrook (1998) discusses the role of the ODP in relation to their duty of care and equipment. In theatres, there are several professional groups practicing and it follows that where diathermy is to be utilized, there is a question over who is accountable for negligence if the patient is harmed in any way? Fulbrook (1998) suggests that whoever prepares the diathermy is ultimately responsible, under The Health and Safety at Work Act (1974) but also argues that this doesn't relinquish the surgeon's duty because they will be using the equipment and the preparation is just part of the procedure for which the surgeon is ultimately responsible. The HPC (2008) ...read more.


Practitioners wear masks which are designed to prevent droplets from the health care professional reaching the patient but do not prevent against the smaller particles present in surgical smoke (Biggins & Renfree 2002). Conclusion When analyzing diathermy, comparisons have been made with cigarettes and how lessons from the past are not being learned. The main question I posed was whether the present guidelines are consistently followed? Currently, I don't believe they are with the main reason being that smoke evacuators are not compulsory, and if diathermy is used without one, legally, there isn't an issue. Guidelines are met more consistently when patient safety is concerned but the same standards aren't always maintained in relation to staff safety. So, it is in the practitioner's best interests to educate themselves to help bring the health risks of diathermy to the forefront of debate. With cost being an issue, pressure needs to be applied through the appropriate channels so that the gap between best practice and action is narrowed. It is the ODP's ethical and professional obligation to understand the value of reflection on practice and to share that knowledge with fellow professionals. Health care practitioners are a vital source of information in the investigation of this issue so they must strive to equip themselves with the relevant information so as they are able to influence future practice for the benefit of the patients and their fellow professionals alike. ...read more.

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