The grounding pad for an electrosurgical unit (ESU) should be placed on clean, dry skin over a large muscle mass, as close to the operative site as possible, but avoiding bony prominences, metal implants, excessive hair, and tattoos. The pad must have uniform contact with the patient's skin to ensure proper current dispersal and prevent burns.
Placement Guidelines
Close to the site:
Place the esu pad as near as possible to the operative area to minimize the current's travel distance through the patient.
Large muscle mass:
Choose a location with good blood supply and over a large muscle to ensure the current is dispersed effectively.
Clean and dry:
The skin surface should be clean and dry to ensure good adhesion and prevent potential skin irritation or burns.
Avoid problem areas:
Do not place the electrosurgical pad over or near metal prostheses, scar tissue, bony prominences, areas of excessive adipose tissue, or tattoos.
Key Considerations
Uniform contact:
The entire surface of the surgical grounding pad should make uniform contact with the skin. Any gaps, folds, or poor adhesion can lead to concentrated heat and burns.
Hair removal:
Hair in the chosen area should be clipped to ensure proper adhesion and good contact between the neutral electrodes and skin.
Moisture:
Keep the patient return pad dry and protected from any fluids that could seep or pool, as this can interfere with the pad's function and increase the risk of injury.
Patient implants:
Before placing the pad, the circulator should ask the patient about any implanted devices, such as pacemakers, and avoid placing the pad near these.