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* * * * It seems that this is an all too common situation in today’s O.R.’s! * Electrosurgical devices have changed and evolved over the years. It has been a journey of safety with each technological innovations making the generators safer and more effective. * “The introduction of the electrosurgery unit contributed to the provision of larger and more extensive exposures; allowed for longer operating times in which greater care could be taken to identify, dissect tumors; and led to a reduction in infection rates and anesthesia risks……” Vender, J.R., Miller, J., Rekito, A. and McConell, D.E. (2005). Effect of hemostasis and electrosurgery on the development and evolution of brain tumor surgery in the late 19th and early 20th centuries. Neurosurgery Focus, 18(4); 1 – 7. In a 1927 lecture in Glasgow, Scotland, Harvey Cushing said, “When I first had the good fortune to see this loop being used bloodlessly to scoop out bits of tissue from a malignant tumour for the purposes of biopsy, I foresaw that a new tool had been put into our hands to facilitate the piecemeal removal of tumours. With Dr. Bovie’s co-operation, during the past few months I have gained sufficient familiarity with the instrument to realize that it holds out untold possibilities for the future of neurosurgery.” From 1927 lecture in Glasgow, Scotland. Horrax, G. (1981). Some of Harvey Cushing’s contributions to neurological surgery. Journal of Neurosurgery, Vol 54, April, 1981; 436-447. This slide depicts a ground referenced generator. This type of generator significantly increases the patient’s risk for burn injury at the return electrode site or at alternate pathway sites. As shown in this slide, the intended circuit is: from wall outlet ? generator ? active electrode ? surgical site ? return electrode ? generator ? through wall outlet to earth ground. However, the current does not have to follow this pathway (circuit). Any pathway to earth ground is a potential avenue. When the