15 Energy Sources in Surgery
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 15.1: Electrosurgery
- 1. Review the concepts of conduction, frequency, and impedance
- 2. Describe the uses and components of electrosurgery
- 3. Distinguish between monopolar and bipolar circuits used in electrosurgery
- 4. Discuss the safe use of the patient return (dispersive) electrode
- 5. List the primary hazards of electrosurgery and explain how to prevent accidents
Lesson 15.2: Laser Use and Safety in Surgery
- 6. Distinguish between capacitive coupling and indirect coupling
- 7. Describe the materials in a smoke plume and how to reduce exposure to the smoke plume
- 8. Describe how lasers are used in surgery
- 9. Recognize different types of laser media
- 10. Discuss safety precautions used during laser surgery
1.
Classroom Preparation
Lesson 15.1: Electrosurgery
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Review the concepts of conduction, frequency, and impedance
- 2. Describe the uses and components of electrosurgery
- 3. Distinguish between monopolar and bipolar circuits used in electrosurgery
- 4. Discuss the safe use of the patient return (dispersive) electrode
- 5. List the primary hazards of electrosurgery and explain how to prevent accidents
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 15.1: Electrosurgery
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Review of Electricity Free Electrons Conduction and Circuits Current and Impedance Voltage ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Electrosurgery Effects of Electrosurgery on Tissues • Electrosurgery Components and Their Use Power Generator ESU Handpiece and Active Electrode ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Electrosurgery Components and Their Use Patient Return Electrode Used in Monopolar ESU Bipolar ESU Fulguration Electrosurgical Bipolar Vessel Sealing Argon-enhanced Electrosurgery Radiofrequency Ablation ANSWER – Textbook • Review Question 1 ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Electrosurgery Components and Their Use Patient Return Electrode Used in Monopolar ESU ANSWER – Textbook • Review Questions 2, 3 ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Electrosurgery Components and Their Use Power Generator ESU Handpiece and Active Electrode ANSWER – Textbook • Review Question 6 • Case Studies 2, 3, 5 ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 15.1: Electrosurgery
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | CONDUCTION, FREQUENCY, AND IMPEDANCE: SLIDES 4-5 | • Introduction • Review of Electricity Free Electrons Conduction and Circuits Current and Impedance Voltage |
| 2 | ELECTROSURGERY: SLIDES 6-7 | • Electrosurgery Effects of Electrosurgery on Tissues • Electrosurgery Components and Their Use Power Generator ESU Handpiece and Active Electrode |
| 3 | MONOPOLAR VS. BIPOLAR CIRCUITS: SLIDES 8-9 | • Electrosurgery Components and Their Use Patient Return Electrode Used in Monopolar ESU Bipolar ESU Fulguration Electrosurgical Bipolar Vessel Sealing Argon-enhanced Electrosurgery Radiofrequency Ablation |
| 4 | PATIENT RETURN ELECTRODE: SLIDE 8 | • Electrosurgery Components and Their Use Patient Return Electrode Used in Monopolar ESU |
| 5 | HAZARDS AND ACCIDENT PREVENTION: SLIDES 10-11 | • Electrosurgery Components and Their Use Power Generator ESU Handpiece and Active Electrode |
Learning Activities (choose one or more to equal 50 min)
| 1 | DISCUSS (30 min) • As a class, discuss the relationship between frequency of waves and the energies produced by them. What energy can be perceived by the senses? What energies are outside the range of human perception? Appropriate Settings: Traditional/online/flipped classroom |
| 2 | INVITE (50 min) • Have a surgeon familiar with electrosurgery come speak to the class. Have him or her review the safe use and describe how to adjust the power and modes of the ESU. • Appropriate Settings: Traditional/online/flipped classroom |
| 3 | INVITE (50 min) • Invite someone familiar with a vessel sealing system to come demonstrate its uses to your class. Appropriate Settings: Traditional/online/flipped classroom DEMONSTRATE (50 min) • Have small groups of students draw simple diagrams illustrating the difference between monopolar and bipolar electrosurgery. The flow of electricity should be illustrated with arrows. Include a third diagram in which monopolar electrosurgery is being performed with the dispersive electrode in poor contact with the patient. Appropriate Settings: Traditional classroom |
| 4 | DISCUSS (30 min) • Discuss the different types of electrosurgery that require a patient return electrode. Appropriate Settings: Traditional/online/flipped classroom |
| 5 | DISCUSS (40 min) • Using the overhead projector, start a list of general safety precautions to follow when using an electrosurgical unit (ESU). Have students discuss ESU safety precautions and build the list as the discussion proceeds. As each precaution is added to the list, ask students to explain the reasons behind each precaution. Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
You’ve been talking to Aunt Emma about your recent lesson on electrosurgery. She wonders why the patient isn’t electrocuted when the ESU is in use. What do you tell her?
Discussion Guidelines: Students might discuss the different properties of electricity and how only certain wave frequencies of electricity are dangerous to the nervous system (which is itself a type of electrical system). An ESU can indeed cause severe burns if it is not used properly, but it operates at such a high wave frequency that it does not interfere with the heart and the nervous system.
Classroom Preparation
Lesson 15.2: Laser Use and Safety in Surgery
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 6. Distinguish between capacitive coupling and indirect coupling
- 7. Describe the materials in a smoke plume and how to reduce exposure to the smoke plume
- 8. Describe how lasers are used in surgery
- 9. Recognize different types of laser media
- 10. Discuss safety precautions used during laser surgery
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 15.2: Laser Use and Safety in Surgery
STUDENT PREPARATION (1 hr)
| 6 | READ – Chapter Heading(s) • Electrosurgery in Minimally Invasive Surgery Capacitive Coupling Direct Coupling • Ultrasonic Energy Safety Precautions Ultrasonic Ablation • Cryosurgery ANSWER – Textbook • Review Questions 5, 10 ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 7 | READ – Chapter Heading(s) • Electrosurgery Components and Their Use Smoke Plume ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 8 | READ – Chapter Heading(s) • Laser Surgery Laser Standards and Regulations How Lasers Work Laser Components Effects of Lasers ANSWER – Textbook • Review Question 7 ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 9 | READ – Chapter Heading(s) • Laser Surgery Laser Media ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 10 | READ – Chapter Heading(s) • Laser Safety Laser Classification Precautions and Guidelines Eye Safety Skin Protection Airway Protection ANSWER – Textbook • Review Questions 8, 9 • Case Studies 1, 4 ANSWER – Workbook • Chapter 15 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 15.2: Laser Use and Safety in Surgery
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 6 | CAPACITIVE VS. INDIRECT COUPLING: SLIDE 13 | • Electrosurgery in Minimally Invasive Surgery Capacitive Coupling Direct Coupling • Ultrasonic Energy Safety Precautions Ultrasonic Ablation • Cryosurgery |
| 7 | SMOKE PLUME: SLIDE 14 | • Electrosurgery Components and Their Use Smoke Plume |
| 8 | LASER USE: SLIDES 15-16 | • Laser Surgery Laser Standards and Regulations How Lasers Work Laser Components Effects of Lasers |
| 9 | TYPE OF LASER MEDIA: SLIDES 17-18 | • Laser Surgery Laser Media |
| 10 | SAFETY: SLIDES 19-21 | • Laser Safety Laser Classification Precautions and Guidelines Eye Safety Skin Protection Airway Protection |
Learning Activities (choose one or more to equal 50 min)
| 6 | DISCUSS (30 min) • Divide the class into groups and assign each group one of the hazards of minimally invasive surgery. Have the students discuss the hazard and ways it can be avoided. Have each group present its summary to the class. • As a class, discuss how ultrasonic waves are used to perform surgery. Note the use of the ultrasonic scalpel and ultrasonic ablation instruments. Discuss specialties and procedures that use ultrasonic energy and the benefits and risks of using ultrasonic energy. Appropriate Settings: Traditional/online/flipped classroom |
| 7 | DISCUSS (30 min) • Discuss as a class the different substances found in a smoke plume and the hazards they may present to the team and patient. • Appropriate Settings: Traditional/online/flipped classroom |
| 8 | INVITE (50 min) • Ask an operator at a medical facility that uses lasers to speak to the class about how the lasers the facility uses serve medical purposes. • Appropriate Settings: Traditional/online/flipped classroom |
| 9 | DISCUSS (30 min) • Discuss the classes of lasers and examples of each. Note that many types of lasers (e.g., those in laser printers) do not represent a health or fire hazard, but that most medical lasers are in class 4, the most dangerous level. • Appropriate Settings: Traditional/online/flipped classroom |
| 10 | DISCUSS (30 min) • Divide the class into groups and assign each an organ (eye, skin, or airway) that can be damaged by laser energy. Ask each group to summarize the types of injury that can occur to that organ and the measures taken to protect that organ. Have each group present its summary to the class. • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
You are walking past a room where laser surgery is in progress and realize you left something on a bench inside the room. The spare pair of protective glasses is missing, so you intend to keep your head and eyes toward the wall as you make your way to the side of the room. Why is this not acceptable?
Discussion Guidelines: Students might discuss the grave danger to eyesight posed by most medical lasers. Even if a person does not look directly at the laser, scattered, or reflected light can cause serious injury. In addition, the unprotected person is assuming that he or she knows where the laser is being pointed and how it is being used at the time; at the same time, the surgical staff is assuming that everyone in the room is appropriately protected. Some lasers will cause injury painlessly, so there may not even be warning of a problem if it occurs. It is simply not worth it for a person to take such a risk.
Assessments
Chapter 15: Energy Sources in Surgery
ASSESSMENTS BY OBJECTIVE
| 1-10 | Workbook • Chapter 15 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 15 – Graded quizzes (Mastery Levels 1, 2, and 3) |
