The dangers of bovie smoke are very real, they can cause cancer, spread diseases, and cause a multitude of lung problems. The AORN is recognizing it as a huge problem now and has a program and a "go clear award" for hospitals that make real effort and progress in reducing their surgical smoke, great video thank you, keep them coming!
Our unit has purchased a Neptune suction device which also has an added feature of smoke evacuation. It's basically a Bovie pencil with a built in suction. Works like a Champ. If you don't have one remember your training and attempt to use standard suction ( yankauer) when the Bovie produces smoke. All CST, ORT and Scrubs Techs should know this basic technique and standard. May I ask how to get the award, recognition?
I have just began my job as a theatre nurse. I find your videos extremly informative and helpful. Thank you so, so much for sharing your knowledge. Greetings from London,UK🙂
The Bovie Machine seems very similar to a welder in the basic principles, i.e you have an electrode and a ground even though one is used for cutting and coagulating tissue and blood vessels and the other is used to join two pieces of metal.
I’m new subscriber and I learned so much. I want to get into sales medical devices and I have learned from all this terminology a dr uses for equipment. Thank you!.
After 25 years of selling and teaching electrosurgery (and introducing the LigaSure...)...you didn’t do a bad job! Good advice on surgical plume hazards. Footnote: RF will blow holes in gloves if not handling the active properly...ie “buzzing a stat” improperly. Everyone thinks they started with pinholes in their gloves 🙄
No, it’s electric frying a person…… It doesn’t necessarily seal, it burns, vaporized and cuts. It has a small helpful side effect of controlling blood with a cauterizing effect. But radiated tissue and highly vascular tissues will continue to bleed. Hence additional measures are required. Silk ties, gauze, metal or plastic vessel clips, staples and suction all help to address bleeding. Then you have chemical hemostatic agents (Floseal, surgicell, fibrillar….etc) Finally you have emergent measures like Cryo, FFP, Packed Red Bloodcells, Factor 7 and so on. The Harmonic Scalpel and Enseal or Ligasure seals as it cuts. As does some special staplers that seal and cut simultaneously. Cheers!
Contraindicated to circumcise infants with electrosurgery! Read the literature and beware of ANY surgeon circumcising babies with monopolar electrosurgery. Tragedies have resulted which would change anyone’s mind!
In the incident you described around the 10:00 mark about electrical arc injuries in surgery from the Bovie… How can a practitioner prevent that? How can a surgeon test for that before surgery and use of the Bovie to be sure their gloves are completely intact? I understand that all that’s required is a hole big enough to let a stream of electrons through, so how can a surgeon test, prevent or assure themselves that their gloves are going to protect them? Is there a standard practice in the OR? Or is the safe way to not allow the situation to evolve to the point that it’s possible for the current to travel through their glove? Something like standard precautions when using Bovie? Thank you in advance if you answer this comment!
That was very interesting, my daughter was and is a OR nurse, & was explaining the bovine to me, she quit nursing because she and I didn’t want to get the shot. She was a nurse for over 20 years, and loved it but has gotten hurt in the OR before. She does miss it though.
is the wire not considered sterile? does it ever hit the floor? who’s responsibility is it to place the grounding pad? do you keep it in that white plastic container when not in use?
myduffzv53 ...avoid placing return electrode (pad) over a prosthesis due to reduced conductivity of scar tissue (it ain’t the metal that’s the problem). Older Pacemakers used to be susceptible to recalibration by microwaves and RF currents. Has been years since an issue. If any further doubts...contact the manufacturer of the patients pacemaker or pt’s cardiologist
If a pt has a pacemaker, where do you place the return pad? Let's say the pt has a right-sided chest implanted pacemaker and you are doing surgery on the neck. Where should the return pad be placed?
Modern pacemakers are shielded from microwaves and RF...BUT...avoid placing the return electrode in the pathway of the pacemaker to the heart. A bicep or left scapula on the back would work for a neck procedure
i’m in the tech industry in entertainment. i love this stuff because its intelligent but i am in no way doing research for my job by watching this. it’s a fun pastime. but force me to watch videos about building complex platforms like netflix or hulu have, and ill be stressed all night.
it would have been nice to show the bipolar outside of its peel pack. its not that much of an inconvenience to re-wrap a singular instrument. Great informative video however
How do you open the bovie and get it on the sterile field without knotting it up or getting mixed up on the cord for too long of a period. Sometimes it is nice and easy and sometimes the the cord is a mess.
HELP! I am new and work in ophthalmology and have started using the bovie more. We always change the tip prior to a procedure and I have yet to find the safest and easiest way to remove and switch the tip. I tried with a hemostat but the hemostats we have are very small and I don’t want to damage it. I also tried with a sterile towel and don’t know what I am doing wrong because there is so much resistance. Thanks in advance
They are out there. Check out the Medtronic Plasma blade. Its a hard sell to use in hospitals when you compare the cost of a simple blade and monopolar bovie vs plasma. ($5 vs $300)
Eric Bayer there’s always the chance a fire could happen but we are trained to recognize when there is a “fire triangle” present, and we do whatever we can to reduce those chances. ie, we turn down the oxygen if a nasal cannula is being used and we are working close to that area, we wait until prep is completely dry before draping, we try not to let fluids puddle or let O2 build up underneath the drapes.
There are many unreported surgical fires every year...most caused by the active electrode being neglected. Not many flammable gases used anymore...tinctures, gels, patient hair, drapes, towels, laps are ALL potential fuels in an O2-enriched environment. (Presented “Preventing Surgical Fires” for CEU’s for nearly 35 years)
Question I had my tubal ligation back 1996 and wanted to know if I can get my tubes tied. I’m not sure if they was burnt. The report I have all it says that the right Fallopian tube was grasped with a Babcock clamp and traced to its fimbriated end. The distal third was suture ligated with a chromic. The second ligature was applied using a plain suture as a security measure. The tube was then resected proximally and distally. The same procedure was done on the other side. The fimbriated ends of the Fallopian tubes were cauterized with the Bovie. What I need to know can my tubes be reversed 🙁🙁🙁
I wish you would’ve talked about when you’re using the Bovee to always put it in the cradle so it’s not lying on the patient Also can you give me some more information on breathing in the plume from the Bovie .... PLEASE THANK YOU
Surgical Tech Tips No Fire 🔥... Just need to be care where your instruments are. You know all this 👍🏽... you know one of my pees when the nurse in the room gets really close to my table...😡 18 inch goes for everybody ....🙋🏻♀️
As a CST or any surgical technician you should always attempt to use the suction to suck up the plume as the Bovie is used. Harder said then done but necessary. Look into Bovie Smoke Evacuaters. We have one in our Neptune suction machine. Works great.
Sold surgical smoke evacuators and gave CEU talks on hazards of surgical plume for decades. Retired now...but plume contains live DNA, benzene, PCAH (polycyclic aromatic hydrocarbons...carcinogenic). Smoke from one gram of tissue contains the mutagenic potential of six cigarettes. Consult the AORN literature on the website. The science is well established. In my experience, many surgeons objected to the bulk of the smoke evac pencils. (They might be exposed to smoke 2-5 hours per week...the techs and scrubs...up to 8 hours per day!)
Question about the surgical caps you always wear. Does the hospital require you to cover your ears or are you just lifting it between surgery to be more comfortable? It seems like you would need to cover everything because you do have some hair poking out by your ears and sideburns.
I work in a animal hospital and when they cauterize, the smoke would fill the treatment area. Man it stinks.. Hopefully by some chance plume isn't as dangerous from animals .__.
You better do some research. No one will do it for you. We were told there was no problem. It's too late for me now. However I do have around 2 good cases of pneumonia yearly!
It's super interesting seeing how different countries do things! We mostly use the grounding mats underneath the patient for grounding instead of the pad to reduce the change of a burn, all depending on the surgeon of course.
There are a lot of differences between the USA and other countries when it comes to surgery that I've seen from your videos. I'm an ODP from the UK (which not many people have heard of) and we do a 3 year BSc training in anaesthetics, scrub and recovery (which includes about 5000 hours clinical practice time). we do the surgical first assist qualification before graduation too, but that's a pretty new opportunity. After qualifying we can go on to do intensive care, emergency care, physician associate or surgical practitioner roles, but that's pretty new too. We don't have many nurses in the operating department anymore, it's mostly ODPs, and we don't have CSTs at all. There are still some scrub nurses, mostly due to the national supply of ODPs being less than demand.
I know that the surgical staff enjoy working with him in the OR because he's so organized and on point with every thing
The dangers of bovie smoke are very real, they can cause cancer, spread diseases, and cause a multitude of lung problems. The AORN is recognizing it as a huge problem now and has a program and a "go clear award" for hospitals that make real effort and progress in reducing their surgical smoke, great video thank you, keep them coming!
Our unit has purchased a Neptune suction device which also has an added feature of smoke evacuation. It's basically a Bovie pencil with a built in suction. Works like a Champ.
If you don't have one remember your training and attempt to use standard suction ( yankauer) when the Bovie produces smoke.
All CST, ORT and Scrubs Techs should know this basic technique and standard.
May I ask how to get the award, recognition?
More videos on all the types of equipment a tech/nurse would work with on the daily would be great too!
Lisa Doherty yep
thank you for your support. As a beginner in biomedical field this channel helped me a lot.
wonderful vid i am learning so much all the way in Trinidad and Tobago.
Thank you! This is a great, real-world, introductory review for RNs and STs new to the O.R. Thank you so much.
I have just began my job as a theatre nurse. I find your videos extremly informative and helpful. Thank you so, so much for sharing your knowledge. Greetings from London,UK🙂
We watch your videos in my surg tech program. Very informative and easy to follow.Thank you!
The Bovie Machine seems very similar to a welder in the basic principles, i.e you have an electrode and a ground even though one is used for cutting and coagulating tissue and blood vessels and the other is used to join two pieces of metal.
I’m new subscriber and I learned so much. I want to get into sales medical devices and I have learned from all this terminology a dr uses for equipment. Thank you!.
Thanks mate. Always wondered how the bovie machine works
After 25 years of selling and teaching electrosurgery (and introducing the LigaSure...)...you didn’t do a bad job! Good advice on surgical plume hazards. Footnote:
RF will blow holes in gloves if not handling the active properly...ie “buzzing a stat” improperly.
Everyone thinks they started with pinholes in their gloves 🙄
Electric cauterization is done during operation to prevent bleeding.
hi, my friend you are the best surgical tech. i have ever been following on you tube may God bless you. michael .
Thanks sir. In our set up we called it diathermy. You called it bovie
The Brits call it Diathermy
I have watched so many videos but this video is vary beneficial for information , appreciable sir , i love it
thank you very much ..... can you please make a video laparoscopy instruments ?
Where would I be if I didn't have this channel
Its basically welding on a person
Interesting Details
No, it’s electric frying a person…… It doesn’t necessarily seal, it burns, vaporized and cuts. It has a small helpful side effect of controlling blood with a cauterizing effect. But radiated tissue and highly vascular tissues will continue to bleed. Hence additional measures are required. Silk ties, gauze, metal or plastic vessel clips, staples and suction all help to address bleeding.
Then you have chemical hemostatic agents (Floseal, surgicell, fibrillar….etc)
Finally you have emergent measures like Cryo, FFP, Packed Red Bloodcells, Factor 7 and so on.
The Harmonic Scalpel and Enseal or Ligasure seals as it cuts. As does some special staplers that seal and cut simultaneously.
Cheers!
BRIDE4JESUS love your style ❤
I'm thankful you for this video. now I know what is the electro surgical unit
Thank u so much for the video
Well this is so crazy ! Literally had my surgical tech tour and walk through at nearby hospital and we saw a circumcision with this tool!
Joshua Aguilar
Plz share ur experience with me sir,
I m keenly interested in the subject u told i.e circumcision through electro-cautery.
Please tell me about it
Contraindicated to circumcise infants with electrosurgery! Read the literature and beware of ANY surgeon circumcising babies with monopolar electrosurgery. Tragedies have resulted which would change anyone’s mind!
@@davidjose9808 What about bipolar?
@@davidjose9808 Do the benefits outweigh the negatives? Does the use of the cautery shorten the operation time? I'm just throwing a few questions in.
Please make a video about anesthesia machine how it is work
Yeah that would be great
Thank for helping on my test!
This is very imformative. Thanks to you too
In the incident you described around the 10:00 mark about electrical arc injuries in surgery from the Bovie… How can a practitioner prevent that? How can a surgeon test for that before surgery and use of the Bovie to be sure their gloves are completely intact? I understand that all that’s required is a hole big enough to let a stream of electrons through, so how can a surgeon test, prevent or assure themselves that their gloves are going to protect them? Is there a standard practice in the OR? Or is the safe way to not allow the situation to evolve to the point that it’s possible for the current to travel through their glove? Something like standard precautions when using Bovie? Thank you in advance if you answer this comment!
I love your channel so helpful and beneficial keep it coming
Amazing video bro Great information!
Hope you do more educational videos on equipment in the OR.
In the UK this is called Diathermy.
Big help, thank you.
Very informative video and nice explaintation......
Well said and so useful, very clear and simple, thank you too.
can you do a video on laparscopic surgery and instruments used along with co2/smoke
great video! thank you!
Thank you for this video
Very useful simple and focused
I’m a fan
you are amazing explaining everything.
I need this think
Keep the videos coming! I use them in my classroom and they are so informative!
Nice work
Thank you 😊
Really sir I am impressed because of your teaching style and in with some little joke also added I like it ❤️👍🏻
Impressive and detailed information, thanks
That was very interesting, my daughter was and is a OR nurse, & was explaining the bovine to me, she quit nursing because she and I didn’t want to get the shot. She was a nurse for over 20 years, and loved it but has gotten hurt in the OR before. She does miss it though.
Thank you very much! This video was a big help! Keep them coming!
Thank you
Thank you so much 👍👍👍
is the wire not considered sterile? does it ever hit the floor? who’s responsibility is it to place the grounding pad? do you keep it in that white plastic container when not in use?
Greatvideo! Very explanatory!
Could you comment on the distance required from the placement of the grounding plate to a patient with hip or knee or pacemaker
myduffzv53 ...avoid placing return electrode (pad) over a prosthesis due to reduced conductivity of scar tissue (it ain’t the metal that’s the problem). Older Pacemakers used to be susceptible to recalibration by microwaves and RF currents. Has been years since an issue. If any further doubts...contact the manufacturer of the patients pacemaker or pt’s cardiologist
Excellent video! (perioperative nurse in training)
Valleylab is now acquired by Covidien (a Medtronic subsidiary).
Awww, I wanted to see a live demo...
If a pt has a pacemaker, where do you place the return pad? Let's say the pt has a right-sided chest implanted pacemaker and you are doing surgery on the neck. Where should the return pad be placed?
K Denti you would use bipolar cauterization where no return pad is used because the current doesn’t go through the pt.
Modern pacemakers are shielded from microwaves and RF...BUT...avoid placing the return electrode in the pathway of the pacemaker to the heart. A bicep or left scapula on the back would work for a neck procedure
Wow I like the video. It has really helped me understand Electro Surgery and the potential hazards, which include electro shock and plume
Great tips
Excellent
Nice surgical device
We can use this in cervical erosin coutery. Mono or bi poler
Bipolar current uses either a tip with a wire loop electrode or a forceps.
If you have watched the HBO series "The Knick", they are using an early version of this ESU.
Thanks so much
Can this button switch pencil can be used for dental implants??
i’m in the tech industry in entertainment. i love this stuff because its intelligent but i am in no way doing research for my job by watching this. it’s a fun pastime.
but force me to watch videos about building complex platforms like netflix or hulu have, and ill be stressed all night.
it would have been nice to show the bipolar outside of its peel pack. its not that much of an inconvenience to re-wrap a singular instrument. Great informative video however
How do you open the bovie and get it on the sterile field without knotting it up or getting mixed up on the cord for too long of a period. Sometimes it is nice and easy and sometimes the the cord is a mess.
Is the size of Cautery tip for Bovie can be 6" or longer
Thanks for your vedio..❤
we dont have a smoke evacuator can we use normal suction from wall or portable.
Thank you for your vid 👍
HELP!
I am new and work in ophthalmology and have started using the bovie more. We always change the tip prior to a procedure and I have yet to find the safest and easiest way to remove and switch the tip. I tried with a hemostat but the hemostats we have are very small and I don’t want to damage it. I also tried with a sterile towel and don’t know what I am doing wrong because there is so much resistance. Thanks in advance
you are best i love you because you work well
The high frequency is what causes that intense and deep pain when the surgeons make a mistake and burn themselves or others.
Wonderful! Thank you :)
Would you say that in the near future that surgeons will exclusively being using bovies instead of actual scalpels
They are out there. Check out the Medtronic Plasma blade. Its a hard sell to use in hospitals when you compare the cost of a simple blade and monopolar bovie vs plasma. ($5 vs $300)
More videos please
It's the bovie monopolar?
How does this not pose a fire hazard given that there’s so many flammable gases in an OR?
Eric Bayer there’s always the chance a fire could happen but we are trained to recognize when there is a “fire triangle” present, and we do whatever we can to reduce those chances. ie, we turn down the oxygen if a nasal cannula is being used and we are working close to that area, we wait until prep is completely dry before draping, we try not to let fluids puddle or let O2 build up underneath the drapes.
There are many unreported surgical fires every year...most caused by the active electrode being neglected. Not many flammable gases used anymore...tinctures, gels, patient hair, drapes, towels, laps are ALL potential fuels in an O2-enriched environment. (Presented “Preventing Surgical Fires” for CEU’s for nearly 35 years)
Correction...25 years
Question I had my tubal ligation back 1996 and wanted to know if I can get my tubes tied. I’m not sure if they was burnt. The report I have all it says that the right Fallopian tube was grasped with a Babcock clamp and traced to its fimbriated end. The distal third was suture ligated with a chromic. The second ligature was applied using a plain suture as a security measure. The tube was then resected proximally and distally. The same procedure was done on the other side. The fimbriated ends of the Fallopian tubes were cauterized with the Bovie. What I need to know can my tubes be reversed 🙁🙁🙁
G Kelly
Then they didn’t
Reanastomosis does not guarantee pregnancy :(
IVF is usually the answer
I wish you would’ve talked about when you’re using the Bovee to always put it in the cradle so it’s not lying on the patient Also can you give me some more information on breathing in the plume from the Bovie .... PLEASE THANK YOU
Great point! Might have to have a "fire Hazards" video and include that stuff in it.
Surgical Tech Tips No Fire 🔥... Just need to be care where your instruments are. You know all this 👍🏽... you know one of my pees when the nurse in the room gets really close to my table...😡 18 inch goes for everybody ....🙋🏻♀️
As a CST or any surgical technician you should always attempt to use the suction to suck up the plume as the Bovie is used. Harder said then done but necessary.
Look into Bovie Smoke Evacuaters. We have one in our Neptune suction machine. Works great.
Sold surgical smoke evacuators and gave CEU talks on hazards of surgical plume for decades. Retired now...but plume contains live DNA, benzene, PCAH (polycyclic aromatic hydrocarbons...carcinogenic). Smoke from one gram of tissue contains the mutagenic potential of six cigarettes. Consult the AORN literature on the website. The science is well established. In my experience, many surgeons objected to the bulk of the smoke evac pencils.
(They might be exposed to smoke 2-5 hours per week...the techs and scrubs...up to 8 hours per day!)
You are from .. I am for soudia I am avilivabl this thinks .. plz halp me
Valeylab Force Fx ??? 😊
vs bovie ?
When my surgeon uses the bovie on me the pad always gets put on my lower leg.
Question about the surgical caps you always wear. Does the hospital require you to cover your ears or are you just lifting it between surgery to be more comfortable? It seems like you would need to cover everything because you do have some hair poking out by your ears and sideburns.
Hospital does not require us to cover our ears. Nor does the surgical cap.
Just yesterday my surgeon get shocked but thank God I wasnt scrub at that time.
I work in a animal hospital and when they cauterize, the smoke would fill the treatment area. Man it stinks.. Hopefully by some chance plume isn't as dangerous from animals .__.
You better do some research. No one will do it for you. We were told there was no problem. It's too late for me now. However I do have around 2 good cases of pneumonia yearly!
I am from soudia I need it
How do you handle sweating while in the OR? Do you have any tips or tricks to help either catch or prevent sweating so much?
I've seen some surgeons wrap their heads in kerlix wrap to help prevent forehead sweat. Thankfully this is a non-issue for me.
Just do hearts and you'll never have to worry about sweating again. Those rooms are freezing!
Thanks guys. As far as cardiac goes. I'm only OB.
An RNFA I worked with used to put cold packs, like the ones we give patients, in a tight fitting undershirt to keep herself cool during cases.
That's great 👍
i fix this stuff. They hurt so damn bad
....return pad not grounding....grounding would result in electrocution
I can’t wait to touch all those instruments 😁 😂
💪🏾☺️✨… ❤️
Hole in the glove is an outcome of a burn rather than the cause of the burn.
What's your name?
I'm a Bovie, always wondered why I was obsessed with antique medical tools and work at the hospital lol
The ploom must smell like BBQ
❤️ Excellant ❤️
Diathermy in the UK
TheJoecoronado and in Australia too.
Interesting.
It's super interesting seeing how different countries do things! We mostly use the grounding mats underneath the patient for grounding instead of the pad to reduce the change of a burn, all depending on the surgeon of course.
There are a lot of differences between the USA and other countries when it comes to surgery that I've seen from your videos. I'm an ODP from the UK (which not many people have heard of) and we do a 3 year BSc training in anaesthetics, scrub and recovery (which includes about 5000 hours clinical practice time). we do the surgical first assist qualification before graduation too, but that's a pretty new opportunity. After qualifying we can go on to do intensive care, emergency care, physician associate or surgical practitioner roles, but that's pretty new too. We don't have many nurses in the operating department anymore, it's mostly ODPs, and we don't have CSTs at all. There are still some scrub nurses, mostly due to the national supply of ODPs being less than demand.
pking8786 I’m a 2nd year ODP. Hi!
Plate patient.....? ... indication....red.... Bipolar.....??????
What 's this??????
Great
How the heck can you suck a smoke from a plume. Being realistic.
❤️
this one burn my wallet too.