LAUSR

Electronic monitoring (known as ‘tagging’) is used in England and Wales to monitor curfews and conditions of a court or prison order, but can interfere with peri-operative interventions, notably diathermy. Tags are not currently inscribed with any electrical safety information. An internet search found little information on this subject. A 2010 document from the Association of Peri-operative Practice (AfPP) in 2010 carried advice on peri-operative care of tagged patients from a Home Office forensic scientist and CovidienMedtronic (Minneapolis, MN, USA) who make electrosurgery devices. The tag communicates using a weak encrypted digital signal with a base unit at the premises the wearer will be at during curfew. The likelihood of electrical interference is ‘negligible and can be ignored’, the device ‘should not be permanently affected by magnetic fields’ and ‘should not interfere with any hospital equipment’ [1]. Covidien-Medtronic stated ‘metal objects such as tags with any metal parts, snaps, clamps or pins could have the potential to conduct electrosurgical current’ and ‘if the monitoring device is locating within the electrosurgical circuit it must be removed’ [1]. They acknowledge that tagging devices may not be easily removable without specialist tools, and suggest ‘non-conductive padding . . .. at the location of the monitoring device to isolate it from the patient’s skin’ if removal is not possible. They felt that there was a potential for the electromagnetic energy to cause electromagnetic interference and ‘recommended the detention bracelet, monitoring tag or other electronic monitoring device be checked postoperatively for proper function before patient discharge’ [1]. We contacted Electronic Monitoring Services advice line about how to remove the tag, or advice about diathermy. They explained that the tag can be removed using scissors, and returned to the patient who should be able to arrange for future re-attachment. They were unaware of any problems related to diathermy. Although these devices are easily removable, we suggest that they should only be removed for surgery near the device or where diathermy safety is an issue.