Didactic Content

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The FUSE didactics are available in Chinese (Simplified), English, Spanish and French to everyone, free-of-charge, at http://www.fusedidactic.org/

At the end of this program, the participant will be able to:

1. Fundamentals of Electrosurgery

Define proper electrosurgery terms
Given a clinical situation, identify the application of Ohm’s Law, power equation, and energy
Identify the function (input and output) of a radiofrequency (RF) electrosurgical generator
Identify the characteristics and differences between monopolar and bipolar instruments
Identify the characteristics of the RF electromagnetic spectrum and why it is used for surgical applications
Identify how RF electrical energy causes effects in cells and tissue
Identify the different effects of ranges of temperature on cells and tissue

2. Mechanisms and Prevention of Adverse Events

Identify general patient protection measures for the electrosurgical unit
Identify various mechanisms whereby electrosurgical injuries may occur
Identify circumstances, mechanisms, and prevention of:
- dispersive electrode-related injury
- direct coupling-related injury
- insulation failure-related injury
- injury due to unintentional activation of the active electrode
- injury due to direct thermal extension from the active electrode
- alternate site-related injury
- capacitive coupling/induced current-related injury
- injury from residual heat from the instrument tip
- energy-related single port access injury
- the operative team can suffer a burn injury
Identify the hazards of the byproducts and smoke produced during electrosurgery
Identify circumstances which promote OR fires and identify prevention strategies
Identify circumstances, mechanisms, and prevention of tracheotomy-related fires
Identify circumstances, mechanisms and prevention of alcohol prep-related fires
Identify how to respond to an OR fire
Identify problems that can occur when simultaneously using multiple energy devices
Identify how to report and handle an adverse device event and meet regulatory requirements

3. Monopolar Instruments

Maximize the use of current density to achieve the desired tissue effects
Describe the clinical effects of changing current densities
Identify the mechanism of action, the proper use of, and potential complications of using argon beam coagulation in electrosurgery
Identify the strategies for the risk reduction for prevention of argon gas embolism

4. Bipolar Devices

Identify the characteristics of basic and advanced bipolar electrosurgical instruments
Identify clinical scenarios when basic bipolar instruments are indicated and identify appropriate power settings for use
Identify performance optimization methods for advanced bipolar instruments
Identify the differences between basic bipolar and monopolar instrumentation as relates to coupling, underwater use, current density, and lateral thermal spread
Identify tissue characteristics that reduce the effectiveness of advanced bipolar instruments

5. Radiofrequency for Soft Tissue Ablation

Identify the differences between typical radiofrequency electrosurgical and radiofrequency ablation (RFA) systems
Identify the indications for application of radiofrequency energy for volumetric ablation
Identify the underlying principles of the volumetric thermal coagulation/RFA system
Identify circumstances, mechanisms, and prevention of RFA-related injury

6. Endoscopic Devices

Identify unique energy tools and complications that can occur when used within a visceral lumen
Identify the steps needed to prepare a patient for an endoscopic procedure that utilizes RF energy
Identify the steps for safe energy use during a polypectomy
Identify the steps for safe energy use when controlling bleeding and vessel sealing utilizing RF energy

7. Ultrasonic Energy Devices

Identify how an ultrasonic generator transforms electrical energy to mechanical energy
Identify the components of an ultrasonic energy system
Identify the mechanism by which ultrasonic devices achieve tissue effects
Identify the factors affecting cutting and coagulation when using ultrasonic devices
Identify the factors affecting safe practice when using ultrasonic devices

8. Microwave Energy Devices

Identify the differences between radiofrequency (RF) energy and microwave energy systems
Identify unique complication patterns associated with microwave ablation and the differences in microwave field zones

9. Energy Devices in Pediatric Surgery

Identify unique anatomic and physiologic differences when performing electrosurgery in infants and children
Identify unique considerations for electrosurgical device settings in infants and children
Identify unique considerations for choice and placement of dispersive electrodes for infants and children

10. Integration of Energy Systems with Other Medical Devices

Identify implanted devices that are affected by RF energy
Identify surgical devices that can cause electromagnetic interference (EMI)
Identify the steps to determine how to use RF energy on a patient (both in the elective and emergent setting) with an implanted electrical device
Identify strategies to minimize interference from RF energy on a Cardiac Implanted Electronic Device (CIED)
Identify potential adverse effects of EMI on a CIED during and after the use of RF
Identify the elements needed for preoperative evaluation, intra-operative monitoring and decision to place a magnet on a patient with a CIED

11. Surgical Smoke and Aerosolization Safety

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