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3 • Additional safety instructions for APC
80114-770_V23802
2021-01
Chapter 3
Additional safety instructions for APC
The safety instructions are structured according to the following risks:
• Fire / explosion
• Burns
• Risks due to gas embolisms or excessive intraluminal gas pressure
• Risk of infection
• Risks due to the environment
Fire / explosion
Hot tissue, combustible materials, and oxygen in the tracheobron-
chial system
Due to APC the tissue can become so hot that it can ignite combusti-
ble materials in the vicinity, e.g. due to hot particles flying around.
Combustible materials are, for example, plastic insulation at the distal
end of the bronchoscope or a tracheal tube.
However, ignition is only possible if a fire-supporting gas, e.g. oxy-
gen, is present at the same time. This particularly applies to highly
concentrated oxygen or pure oxygen.
Risk of burns to the patient!
Do not admit any oxygen to the tracheobronchial system directly
before, and particularly during, APC. Do not admit any other com-
bustible or fire-supporting gases (e.g. nitrous oxide) or combus-
tible liquids either.
If APC is used for a lengthy period of time: Administer the oxygen
required for patient ventilation and APC alternately.
The distal end of the APC applicator must always be in the field of
view of the endoscope before and during activation of the argon
plasma. Never activate the argon plasma without visual control.
Keep the argon plasma as far as possible away from combustible
materials.
Combustible gas mixture in the tracheobronchial system
Hemostasis and devitalization of tissue produce smoke. In conjunc-
tion with oxygen a highly combustible gas mixture develops.
Risk of burns to the patient!
Short activation pulses reduce development of the gas mixture.
Extract the gas mixture.