1. Bordelon, Sandra Jones BSN, RN

Article Content

To the Editor:


In the May/June issue of Gastroenterology Nursing, 28(3), the article "Cautery and Implanted Cardiac Defibrillators," proved to be the spark that moved our nursing staff in endoscopy to seek a better understanding of:


* Basic pacemakers and implanted cardiac defibrillators' (ICD) function.


* The effect of electromagnetic interference on pacemakers and ICDs.


* Device behaviors during magnet application.



The entire nursing staff knew to apply the magnet if cautery was used in the care of the patient, but as expressed in the article, had many concerns related to what effect this would have on the device.


To meet our objectives, we contacted the Clinical Nurse Specialist in the Pacemaker Clinic at our institution for an in-service. She immediately offered to contact the representative from Medtronic and together, their presentation answered all of our questions. Medtronic also provided the endoscopy suite with a magnet for each procedure room and our emergency carts that are used in the intensive care units.


In endoscopy, our most frequent use of cautery is unipolar in short burst during polypectomy. To ensure patient safety we:


* Apply the magnet.


* Monitor the electrocardiogram for rate and rhythm changes.


* Place the grounding pad as far from the device as possible with complete adherence to the skin.


* Initiate cautery only when the tip is in contact with tissue.



Bipolar cautery used in coagulation has the electrical current flowing between two small electrodes on the tip of the probe. This is the preferred method of cautery in patients with ICDs and is used frequently in endoscopy.


Gastroenterology Nursing once again hit the mark of excellence by publishing pertinent information that nurses need to feel confident in providing nursing care. It is an excellent source to help our nursing staff keep abreast of new knowledge and maintain the standards of care for our department. We look forward to each issue. Keep up the good work.


Sandra Jones Bordelon, BSN, RN


(e-mail:, Michael E. DeBakey Veterans Affairs Medical Center, Region 53, Greater Houston