CSA Z387:19 Safe use of electrosurgical medical devices and systems in health care.
4.1.3 Procedures
The health care setting shall have procedures for electrosurgical medical devices and systems that address
a) personnel education, training, and orientation covering the
i) operation of ESUs;
i) servicing of ESUs; and
ili) maintenance and utilization of ESUs (e.g, correct application of the dispersive electrode, correct wattage);
b) purchasing (see Clause 5);
c) incoming inspection and installation;
d) operation; and
e) regular maintenance and repair.
4.2 Education, training, and orientation
Electrosurgery education shall be undertaken by all personnel (e.g., physicians, nurses, and support staff) involved in the application of electrosurgical energy, including
a) fundamentals of electricity and electrosurgical energy, including
i) familiarity with electrosurgical medical devices;
i) required power settings;
li) effects and types of electrosurgical current (e.g. monopolar, bipolar);
iv) type and appropriate application of waveforms (e.g., cutting using low voltage, coagulation using high voltage, blended); and
v) principles of active electrode devices;
b) potential thermal injuries from the active and dispersive electrodes, especially during endoscopic procedures, and how these injuries may be mitigated; and
c) requirements for surgical plume evacuation shall be according to CSA Z305.13.
Education for physicians should also include hands-on experience using various devices and methods to understand the biological and physical effects of electrosurgical current on tissue.
4.3 Electrosurgery safety committee
4.3.1 To ensure the safe use of electrosurgery, the health care setting shall establish or charge an electrosurgery safety committee for oversight of electrosurgery safety to
a) develop, review, and implement safety standards and clinical practice guidelines for nurses, physicians, and surgeons using ESUs and other energy-based devices;
b) support the educational programs (e.g., courses, labs, preceptorship) and arrange for the regular refresher safety training for users (provided by in-house Clinical Engineering, vendor, or third-party institutions) for local and visiting consultants, surgeons, fellows, nurses, technicians, and residents. An evaluation mechanism should be part of the educational program;
c) coordinate or recommend the acquisition and maintenance of ESUs and other energy-based devices;
d) make recommendations regarding the qualification of physicians and communicate these recommendations to the chiefs of services and medical affairs credentialing committee;
e) review and recommend electrosurgery safety procedures for the protection of patients and personnel; and
CSA Z387 pdf download.