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interference (EMI) and electromagnetic disturbance from electrosurgery/electrocautery devices, apex locators, lasers, electric handpieces, radiation, and other electronic sources. Additionally, vasoactive drugs, such as epinephrine-containing local anesthetics and other sympathomimetics that may be administered during anesthetic management, may have significant effects upon patients who suffer from tachyarrhythmias. Several guidelines have already been promulgated for surgeons and anesthesia providers in the medical field, and parallel treatment decisions can also be

have long been a peril of surgery, 20 especially during the period when the most prevalent anesthetics were flammable. 10 Barker and Polson 21 may have been among some of the first to attempt to identify and recreate the conditions of an actual operating room fire. With the decline in use of flammable anesthetics, the general concern for and awareness of fire safety in the operating room declined 10 ; this awareness has yet to return to previous levels. 22 , 23 Subsequently, the vastly increased use of laser and electrocautery equipment has reintroduced an

endotracheal tube during general anesthesia, 10 or most commonly through the administration of supplemental oxygen, typically with a nasal cannula. 5 Moreover, for all types of surgery, the majority of fires have affected the upper torso, head, and neck region, 5 , 9 while lasers and electrocautery equipment most frequently provide the source of ignition. 5 , 11 The Anesthesia Patient Safety Foundation along with accepted industry safety protocols cite the use of ignition sources such as laser or electrocautery equipment in oxygen-enriched environments as the most

Dental treatment, 185 Dentistry, 31, 139 Desflurane, 42, 91 Diagnosis of anaphylaxis, 160 ED 95 , 147 Ehlers-Danlos syndrome, 204 Electrocautery, 95 Electromagnetic interference, 95 Electrosurgery, 95 Emanuel syndrome, 201 Emergency medicine, 62 Epinephrine, 17, 71 Gag reflex, 181 General anesthesia, 31, 91, 156, 201 Health care quality improvement, 192 Hemoglobin A1c, 208 Hyperglycemia, 208 Hypermobility type, 204

. The use of certain instruments such as electrocautery can interfere with the function of pacemakers and ICDs. Between the 2 forms of electrocautery available, bipolar is preferred over monopolar for patients with pacemakers and ICDs. In the bipolar form, the active and returning electrodes are together at the site of cauterization, whereas the monopolar form utilizes the patient's body as a ground. The grounding pad usually is positioned on the thigh, which carries the returning current back to the machine. The main concern with the use of electrocautery is that the

significantly reduced change from 88 ± 11 mg/dL to 103 ± 12 mg/dL. 26 The use of electrocautery and insulin pumps is a potential concern that would ideally involve interrogation with the device's manufacturer. The primary concern with the pump involves possible electromagnetic interference that would cause damage or subsequent pump failure, although this occurrence has not been documented. 13 Localized burns or superficial damage to the skin is not of significant concern. Pumps have been used safely concurrently with surgical electrocautery, but it is prudent to