TIME TO UPGRADE It's time to upgrade your power tools if your surgeons complain that their drills and saws are jamming and locking.

Orthopedic surgeons want their power tools to go vroom-vroom. What else do they like in their toys? "For drills, I look for good power, quiet and long battery life," says John D. Kelly IV, MD, a sports-shoulder specialist from Philadelphia, Pa. "Portable drills should be lightweight, and you must be able to quickly and easily change the battery pack. I also like drills with quick-release, adjustable chucks. For saws, quiet and good power, obviously."

GUNNING FOR POWER Orthopedic surgeon Brett Sanders, MD, at Memorial Mission Surgery Center in Chattanooga, Tenn.

Horsepower and battery power
Yes, orthopods want to squeeze the trigger and go. They want to cut through bone or sink a screw with power and precision.

Charleston, S.C., orthopedic surgeon David Geier, MD, recalls a few cases when his drill failed him: During an ACL repair the drill wasn't strong enough to complete the tibial tunnel, and during another the battery gave out an hour into the case. Lack of horsepower and lack of battery power: definitely 2 things to avoid.

"You need a drill that has some power to it," says Dr. Geier. "We had some older drills that would get halfway in and would grind to a stop because they didn't have enough power."

Just as frustrating as a drill that lacks torque and speed is a drill battery that quickly loses its charge. "That's really frustrating," says Dr. Geier, who defines "quickly" as draining after 30 minutes of drilling through bone or using a saw attachment. "Just as there's a difference in drills and saws, there's a difference in batteries. Be willing to spend the extra money to get a drill that's reliable."

Dr. Geier's rule of thumb: A battery should at least last an entire case. Still, he recommends you have multiple batteries charging at a time to stay on the safe side. Batteries are critically important because most surgeons prefer cordless drills, which offer less clutter, more mobility and freer movement. Cordless drills also eliminate the possibility of a non-sterile cord falling or being pulled into the sterile field.

Bottom line: You don't want to have a few expensive drills sitting on your shelves for weeks at a time, unwanted and unused, their reputations for lack of power or battery strength making them last resorts for your doctors.

Another key Dr. Geier wants in his drill and saw sets are universal adapters that let you mix and match attachments from different manufacturers for different procedures and uses. "Drills, saws and drill bits are single-use pieces of equipment," he says. "You can't afford to only be able to use them for 1 type of procedure. The more you can use them for multiple procedures, the better." Surgeons might prefer battery-powered handpieces, but keep in mind that oscillating saws and drill bits don't always fit on all cordless drills, says Carole Faucette, RN, the surgery manager at Memorial Mission Surgery Center in Chattanooga, Tenn.

PURCHASING PEARLS

What to Look for When Buying Power Tools

1. Compatibility with your existing system, whether it's battery-operated, run off compressed air or a power console.
2. All-in-one systems where you can interchange tips, depending on the procedure.
3. Torque, as different procedures require appropriate power.
4. Lightweight, which most surgeons prefer.
5. Reliability. Service records should indicate you've purchased a reliable system.
6. Are the units autoclavable or can you use alternative sterilization methods? It helps if a system can be sterilized with more than 1 method.
7. Ease of cleaning and decontamination.
8. Cost and service.
9. Availability of a loaner if the tool goes down.
10. Durability.

— Stephen Anthony Espinosa, RN, BSN, CNOR, RNFA, LSS

Mr. Espinosa ([email protected]) is director of human resources, technology and material management at the Specialty Surgical Center in Sparta, N.J.

Reprocessing considerations

Memorial Mission Surgery Center's 4 ORs hosted 3,715 orthopedic procedures last year. That's a lot of wear and tear for the facility's 8 power tools: 4 plug-in drills, 2 cordless drills and 2 oscillating saws. It's also a challenge to reprocess the instruments and keep them in action without delaying cases.

When making up the day's schedule, Ms. Faucette considers how many cases will need power tools. "You have to have enough on the shelves," she says. "Sometimes you have to shuffle cases around a little bit so you can reprocess in a timely manner."

Of course you'll know it's time to upgrade your power tools if your surgeons complain that their drills and saws are jamming, locking or otherwise not operating as effectively as they should. Ms. Faucette keeps an eye on 2 other indicators. "When you don't have enough gaps in the schedule or enough time to reprocess and you're sending tools out for repair a lot because of wear and tear, it might be time to put another [drill or saw] on the shelf," she says.