Archive September 2017 XVIII, No. 9

Staff Safety: Standing up for Surgical Smoke Safety

The staff at Dosher Memorial Hospital banded together to protect themselves — and surgeons — from the dangers of toxic plumes.

Daniel Cook

Daniel Cook, Executive Editor


2017 OR Excellence Award: Staff Safety
total team effort ALL FOR ONE It took a total team effort to achieve 100% compliance with using smoke evacuators during plume-generating cases.

Ten minutes. That's all the time Kim York, BSN, MS, RN, CNOR, CSSM, had to make her case for smoke evacuation to the hospital board, medical board and surgical committee at Dosher Memorial Hospital in Southport, N.C.

"I had to stuff a lot of convincing information into my PowerPoint slides," she says.

Among the smoke-evacuation selling points she included in her timed talks: The ablation of 1 gram of tissue produces a smoke plume with an equivalent mutagenicity to 6 unfiltered cigarettes, and that each year, an estimated 500,000 workers, including surgeons, nurses, anesthesiologists and surgical technologists, are exposed to laser or electrosurgical smoke.

"I tried to scare them into supporting me," says Ms. York, with only a hint of sarcasm. She was surprised to learn that some board and committee members didn't know about all the dangers of surgical smoke: "They were shocked about the things I told them."

The hospital's higher-ups were coming around to the idea of making surgical smoke evacuation mandatory, but Ms. York still had to convince surgeons wary of using loud, bulky evacuators. Her plan was somewhat unorthodox.

"We removed all reading material from our bulletin boards and break room," she says, "and replaced it with literature about the dangers of surgical smoke."

She also gathered as many trial smoke evacuators as she could from manufacturers and spread them out across the break room table. Members of the OR team, including those hesitant surgeons, had to pick up a device in order to find a place to eat. "That forced everyone to share what they liked and didn't like about the different options," says Ms. York. "It got people talking about the topic."

Based on those impromptu chat and chews, the surgical team settled on 2 options to trial. Ms. York still had to persuade surgeons to give the new devices a fair shake. Part of their resistance was rooted in the older, bulky evacuators they'd used years ago. "We knew they had trialed a cautery pencil that plugged into a loud, little evacuator you had to carry from room to room," says Ms. York. "We had to fight that battle, too."

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