I do not claim to be an expert I am just reporting what I have seen.
At my previous hospital, which was a cardio-respiratory specialist centre, they did lots of by-pass grafts with two teams of surgeons operating at once. One opening the chest and the other harvesting the graft from the leg or arm.
They had two Tyco Valleylab ForceFX machines and before that two Escmann TD411 machines operating at once.
By placing the return electrodes near the operating site there were no problems.
I hope this is plain enough, simple enough and non-controvesial. It is an observation not a prescription or an instruction.
We also had some old GU Solstars around, these had earth referenced outputs. If these were used in the above situations in place of one of the machines, the newer one, of either make, alarmed as it thought that its plate or the patient was touching earth. Which effectively was what was happening.
Now to the controversial bits.
I believe as technicians we can only offer advice and that the clinicians make the decisions based on that advice. So the buck stops with them as they are legally responsible for the care of the patient. Professionally we should give the best advice possible.
Under the Health and Safety at Work Act we are obliged to bring to the appropriate person's attention any hazardous or potentially hazardous situation. If we do not then we are liable under the law. If we do, then it up to the responsible person to sort out the hazard.
So I believe we can tell the clinicians we believe something is incorrect (in writing to prove you did it), advise them on a suitable action and then leave them to do what they think appropriate and to take the consequences of their actions.
I also believe that they do not have enough specialist knowledge in certain technical areas to know the actual correct action so this means that our advice should be sound but it is still up to them whether they act on it or not.
I used to be part of a ward based clinical support team and our phrase to new doctors was "usually in this situation the team did....." We carefully phrased it so we were not telling them what to do, but were in reallity. But they were responsible for their action and could not say "But the technician told me to do...."
Lets face it, through experience and speciallist knowledge we probably do know more than the clinicians in certain areas so they are relying on us to help them out but if something is wrong they take the can.
There have been postings worrying about technicians problems we can always say we advised, the clinicans cannot hide away....as much as they might try.
Robert
Issued in good faith as a personal opinion.
There, does that get me out of the brown stuff?
