Cultivating Quality: Implementing Surgical Smoke Evacuation in the Operating Room

Overview Inspired by a presentation at an educational conference, two operating room (OR) nurses at Children's Hospital Boston raised concerns at the hospital's perioperative evidence-based practice committee meeting about the potential hazards associated with exposure to surgical smoke and aerosols. The nurses initiated a safety project involving the use of smoke evacuation devices in ORs. The subsequent policy development took two years and involved a literature review, a survey of other institutions, and the support of numerous stakeholders. A utilization review and supportive educational initiatives are ongoing.

[1]  M. Baggish,et al.  The effects of laser smoke on the lungs of rats. , 1987, American journal of obstetrics and gynecology.

[2]  A. Easty,et al.  ELECTROSURGERY SMOKE: HAZARDS AND PROTECTION , 1996, Journal of clinical engineering.

[3]  O'Grady Kf,et al.  Electrosurgery smoke: hazards and protection. , 1996 .

[4]  W L Barrett,et al.  Surgical smoke: a review of the literature. Is this just a lot of hot air? , 2003, Surgical endoscopy.

[5]  Jennifer L. Topmiller,et al.  Factors affecting emission collection by surgical smoke evacuators , 1990, Lasers in surgery and medicine.

[6]  A. Ferenczy,et al.  Human papillomavirus DNA in CO2 laser‐generated plume of smoke and its consequences to the surgeon , 1990, Obstetrics and gynecology.

[7]  R. Allardyce,et al.  COMPOSITION OF VOLATILE ORGANIC COMPOUNDS IN DIATHERMY PLUME AS DETECTED BY SELECTED ION FLOW TUBE MASS SPECTROMETRY , 2007, ANZ journal of surgery.

[8]  S. Garber,et al.  Surgical smoke: a review of the literature , 2003, Surgical Endoscopy And Other Interventional Techniques.

[9]  P. Hallmo,et al.  Laryngeal papillomatosis with human papillomavirus DNA contracted by a laser surgeon , 2005, European Archives of Oto-Rhino-Laryngology.

[10]  Lisa M Brosseau,et al.  Surgical mask filter and fit performance , 2008, American Journal of Infection Control.

[11]  M. O’Banion,et al.  Viral disease transmitted by laser-generated plume (aerosol). , 2002, Archives of dermatology.

[12]  Peter Seipel,et al.  Aerosols Created by Some Surgical Power Tools: Particle Size Distribution and Qualitative Hemoglobin Content , 1991 .

[13]  K. Stenson,et al.  Effects of plume produced by the Nd:YAG laser and electrocautery on the respiratory system , 1993, Lasers in surgery and medicine.

[14]  A. Cuschieri,et al.  Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment , 1998, Surgical Endoscopy.

[15]  R. Clay,et al.  Microbiologic activity in laser resurfacing plume and debris , 1998, Lasers in surgery and medicine.

[16]  Brenda C Ulmer,et al.  The hazards of surgical smoke. , 2008, AORN journal.

[17]  M S Baggish,et al.  Protection of the rat lung from the harmful effects of laser smoke , 1988, Lasers in surgery and medicine.

[18]  R. Reiman,et al.  Results of a survey on current surgical smoke control practices. , 2008, AORN journal.