Here are the facts:
1. Fact: Jewelry does not increase the risk of an alternate site burn from an active electrode. If your patient is already attached to a grounding pad, and you touch her earring with an active snare (power pedal engaged), she will likely receive a burn on her earlobe. However, if you touch that patient’s earlobe with an active snare, even if they are not wearing an earring, they will likely get a burn! The culprit is the unintended activation of a live monopolar electrode (i.e. snare or other accessory) touching a grounded patient in some other place (alternate site) than the diseased target tissue (a polyp for example).
The real safety lesson to learn here is to fastidiously manage active electrodes. Taking off her jewelry won’t protect the patient from someone carelessly laying an active snare on the bed while answering a page.
The same principle holds true for a break in any cable insulation. The patient (or the caregiver) may be shocked or burned at the break site whether they wear jewelry or not. Don’t use insulation-compromised equipment!
2. Fact: You do NOT have to put tape, either under or over a ring, to protect a patient from burns from stray (or leakage) radiofrequency current. AORN states, “Although there may be other reasons for removal of all patient jewelry (risk of swelling, theft) the risk of an alternative site injury from stray current is negligible."
It is true that some radiofrequency current does "stray" from the circuit path during the application of electrosurgery—we sometimes see it as interference on a video monitor—but the small milliamps of energy escaping from a modern generator unit are not enough to cause burns.
