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Archive June 2013 XIV, No. 6

Yes, You Can Have a Smoke-Free OR

How to convince your staff and your surgeons that smoke evacuation is essential.

Lizbeth Bozeman, RN, CNOR


surgical smoke HEALTH HAZARD Surgical smoke is hazardous, whether it's visible or invisible, odoriferous or odorless.

If you can't see it and you can't always smell it, then it must not exist. That's often the attitude toward electrosurgical smoke. But smoke from electrosurgical devices does exist and research shows it can be as dangerous as any laser plume you can see, smell and measure.

Many of our nurses are certified through AORN and participate in organization activities, closely watching new guidelines and standards. Smoke evacuation in the OR is a basic AORN principle.

When it came to laser smoke, because you could see and smell the particulates, it was an easy sell to convince staff and surgeons of the dangers. We adopted and embraced smoke evacuation early on.

But when electrosurgery became more prevalent, that was a different matter; it wasn't recognized that this surgical method produces smoke just like laser surgery. With electrosurgery, you may not see the plume because it is so finite, and you can't always smell the particulates. But just as in laser surgery, these particulates contain blood, dead and living material, potentially infectious viruses and bacteria, as well as potentially hazardous chemicals such as acrolein, benzene, formaldehyde, toluene and polycyclic aromatic hydrocarbons. Research has shown contaminants have carcinogenic potential.

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