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Archive June 2020 XXI, No. 6

Stop Breathing in Surgical Smoke

Joint national grassroots efforts to keep pushing for evacuation in every OR.

Joe Paone

Joe Paone


TIME TO RECONSIDER Some surgeons who had negative experiences with earlier versions of smoke evacuation pens might benefit from a fresh look at new systems.

Awareness continues to develop around the negative health effects of surgical smoke, which contains harmful chemicals, carcinogens, bacteria and viruses. Spending a full day working smoke-producing cases is said to be equivalent to inhaling more than a full pack of cigarettes. Still, many surgical teams throughout the country operate in ORs without smoke evacuation.

Two simultaneous efforts are well underway to make smoke evacuation mandatory in ORs across the country that collectively employ a carrot-and-stick approach. Nurses and other clinicians at facilities and health systems have launched grassroots efforts to evangelize, educate and win organizational support for smoke evacuation. Meanwhile, in the interest of leveling the playing field, nurses and other stakeholders are working to pass local laws and regulations that ensure the use of smoke evacuation systems.

Working the inside

Andrea Dyer, MSN, RN, an OR travel nurse currently based at Boston Children's Hospital, has made it her mission to advocate for smoke evacuation systems within her own institutions and with legislators. Like many surgical professionals, she once had no idea about the harm in which she was placing herself in every day.

Then she temporarily shifted away from working in the OR. "My asthma got better, my skin rashes went away," she remembers. "I'd think about my best friends in the OR, still breathing in smoke, and was even more motivated to push for mandatory evacuation."

Ms. Dyer interacts whenever she can with legislators; for example, she worked closely with the Association of periOperative Registered Nurses (AORN) on advancing legislation in Oregon before she moved back east. For Ms. Dyer, it's about getting the right message in front of the right people, because there are still large knowledge gaps among public officials, healthcare executives and many clinicians. She's determined to spread the word to all of them.

If you're looking to become a smoke evacuation champion, it's important to establish credibility with newcomers around the concept. "I start with education and awareness," says Ms. Dyer. "I build a rapport first, personally relate to people. Then I explain that there are more than 150 chemicals in surgical smoke, and it's worse than cigarettes because we're filtering live viruses such as hepatitis in our lungs.'"

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