Notes on Safety in the Medical Specialties • 3
7
APC in bronchoscopy
WARNING! Argon plasma coagulation in a non contact procedure. Do not
hold the distal end of the activated applicator against or insert it into tissue.
Emphysemas can result.
WARNING! When using argon plasma coagulation, argon flows into the
lumen of the organ. The intraluminal gas pressure increases if the argon cannot
simultaneously escape from the lumen or is not extracted. Monitor the
intraluminal gas pressure regularly.
The high temperature of argon plasma can cause flammable materials to ignite
if oxygen or other flammable gases are nearby or are mixed with argon when
applied to these materials (for example plastic insulation at the distal end of
the bronchoscope or a tracheal tube). This is especially true of highly
concentrated or pure oxygen. for this reason, please observe the following
rules:
• Never permit oxygen, other combustibel gases or fluids to enter the
tracheobronchial system before or above all during APC.
• When using APC for more than a few seconds, alternate oxygen ventilation
of the patient with APC, that is, use them in turns.
•
Always keep the distal end of the APC applicator in view in the endoscope
before and during activation of the argon plasma. Never activate APC if
you cannot see the distal end.
ATTENTION: Due to the relatively high-frequency voltages required for
APC, interference can occur in video systems. Digital video systems are
normally less sensitive to this interference than analog systems.
WARNING! APC is a monopolar high-frequency surgical procedure in which
high-frequency electrical current flows through the body of the patient to the
neutral electrode (grounding pad). In case of doubt, when operating on a
patient with cardiac pacemaker, consult the patient’s cardiologist concerning
the risk involved using APC. This applies in particular to APC application in
the thoracic region.
Emphysemas
Intraluminal gaspressure
Danger of burns
Cardiac pacemakers
Video interference
WARNING!
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