Electrocution hazards associated with electrical monitoring devices have recently received attention. The recurring problem of accidental electrosurgical burns has received less publicity. Most such burns are caused by faulty attachment of the patient ground plate. This plate provides a low-current-density pathway for the highfrequency cautery current. Failure of this pathway results in burns at body areas in contact with other fortuitous ground points. Battery-clamp types of connectors are most unreliable and should not be used to attach the ground plate. Built-in, ground-circuit monitors may warn of a failure in the connection to the ground plate but not of failure of contact between patient and ground plate. Especially serious burns can result from failure of the ground circuit if a patient is connected to other electrical devices in addition to the electrosurgical unit.
Battig CG. Electrosurgical Burn Injuries and Their Prevention. JAMA. 1968;204(12):1025-1029. doi:10.1001/jama.1968.03140250005002