Surgical smoke generated from operating equipment is a health hazard for patients, perioperative nurses, surgeons and healthcare staff. Many states have passed legislation requiring the elimination of surgical smoke, and affected health systems are now working to comply.
In a July Becker's Hospital Review webinar sponsored by Stryker Surgical Technologies, six healthcare experts shared personal stories of harm resulting from surgical smoke, efforts to change legislation and policy and technology solutions available to eliminate this problem. Panelists were:
- Julie-Ann Greenhalgh, RN emeritus, The Miriam Hospital (Providence, R.I.)
- James Howarth, brand manager, Stryker Surgical Technologies
- Thomas Kraus, clinical educator, perioperative and procedural areas, Honor Health Thompson Peak and Sonoran Medical Center (Scottsdale, Ariz.)
- Jennifer Pennock, associate director, governmental affairs, Association of PeriOperative Registered Nurses (AORN)
- Melony Prince, clinical expert and staff nurse, Littleton Adventist Hospital (Littleton, Colo.)
- Kimmy Sullivan, medical education lead, Stryker Surgical Technologies
Four key takeaways were:
- Surgical smoke is a significant hazard in operating rooms. Surgical smoke refers to the gaseous byproduct that develops as a direct result of the destruction of tissue by electrosurgery, lasers, electrosurgery, drills and saws. "These technologies, while critical for patient care, produce a smoke that is an unwanted consequence for everyone in the operating room," Ms. Sullivan said. "The smoke is visible, smells bad and most importantly, is hazardous. Studies show approximately 150 known chemical and carcinogenic components identified in surgical smoke, which can have short- and long-term health risks on those exposed." Electrosurgery is used in more than 80 percent of the approximate 24 million U.S. surgeries, exposing more than 500,000 healthcare workers every year, and perioperative nurses report twice as many respiratory issues as compared to the general population.
- Personal health tragedies are driving change. Ms. Greenhalgh worked in an operating room for more than 42 years. She realized that her chronic sore throat, runny nose and infections resulted from surgical smoke — and began to petition for change. Today, she relies on a host of inhalers to breathe. "The last year that I worked, I was on antibiotics nine times in 12 months because of surgical smoke," she said.
Ms. Prince began her activism after a fellow nurse and surgeon suffered from nasal pharyngeal issues that ultimately resulted in cancer. Mr. Kraus also had three colleagues develop various cancers after working in operating rooms for more than 25 years.
- Education and leadership are paramount to successful changes in hospital policies and state legislation. "We've got tools and a roadmap to perform a gap analysis and complete trials," Ms. Prince said. "The evidence is overwhelming. I think you should go the policy route first, ensuring that medical directors, chief medical officers and your C-suite support the initiative. If that doesn't work, then perhaps go the legislative route."
According to Ms. Pennock, surgical smoke evacuation legislation has expanded across the country over the last three years. "To date, nine states have enacted surgical smoke evacuation legislation just this year," she said. "We anticipate approximately 10 more taking up legislation in 2023."
- Stryker offers a wide range of tools and solutions to eliminate surgical smoke. "We have a comprehensive smoke evacuation portfolio to help you and your facilities go smoke free," Mr. Howarth said. Stryker's smoke evacuation pencil can be plugged into both a standard and compact waste management system for open procedures, and the company also offers solutions for laparoscopic surgeries. "We have a plethora of smoke education courses as well as our mobile lab," he added. "We love spreading the word to make everyone aware of how important it is that we go smoke free in our institutions."
Educating healthcare leaders and state legislators about the dangers of surgical smoke and investing in the right tools and technologies are necessary steps to improve the safety of hospital operating rooms around the country.
To view the recording of this webinar, click here.
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