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Microshock — FRCA Primary MCQ

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HardPhysics & Clinical MeasurementMicroshockFRCA Primary

A patient with a left pectoral pacemaker undergoes right-shoulder surgery using monopolar electrosurgery. Which return-electrode position best keeps the current path away from the generator and leads?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — The right thigh, directing current down the ipsilateral side

The best answer is “The right thigh, directing current down the ipsilateral side”. The return electrode should create the shortest practical current path that does not cross the pulse generator or leads. From a right-shoulder field, the right thigh directs current down the ipsilateral side, away from a left pectoral device. Positioning the return electrode near or across the generator increases electromagnetic-interference risk.

Reference: British Heart Rhythm Society, Guidelines for the peri-operative management of people with cardiac implantable electronic devices: https://doi.org/10.1111/anae.15728