The annual Association of periOperative Registered Nurse (AORN) Global Surgical Conference & Expo, which took place this year in New Orleans, Louisiana, featured a poster that honed in on a crucial and often overlooked hazard within operating rooms – surgical smoke. Authored by Alexis J. Carlson, MSN, RN, CNOR, the poster titled “227 – Up in Smoke: It’s Time to Clear the Air and Call for Nation-wide Smoke Evacuation”, emphasized the pressing necessity for standardized protective measures for both patients and healthcare professionals.
Carlson, who serves in the capacity of Operating Room Operations Officer with the United States Air Force Nurse Corps in Las Vegas, Nevada, spotlighted the widespread exposure to surgical smoke. Each year, surgical smoke, which typically emanates during procedures involving electrocautery or laser devices, affects over half a million healthcare workers nationwide. Though primarily composed of water vapor, approximately 5% of surgical smoke can consist of potentially harmful substances such as chemical fragments, particulates, and pathogens, transforming the hazard into a major occupational health and patient safety concern.
Drawing attention to the severity of the problem, the poster compares the surgical smoke produced in an operating room in a single day to the smoke inhaled from smoking 27 to 30 cigarettes. Regular exposure to surgical smoke has been tied to various health concerns and respiratory symptoms among healthcare personnel. For patients, particularly those undergoing laparoscopic and robotic procedures, the smoke can obstruct visualization, escalate the absorption of toxic by-products, and increase carboxyhemoglobin levels.
While 18 US states have put compulsory surgical smoke evacuation laws into effect, the absence of a nationwide standard leads to disparities in safety measures across different regions, sparking fears around equitable and consistent healthcare provision. Highlighting evidence-based recommendations from AORN’s Perioperative Guidelines, coupled with guidance from entities such as the National Institute for Occupational Safety and Health, the National Fire Protection Association, and the American National Standards Institute, the poster underscored the need for systematic reduction in exposure to surgical smoke.
Additionally, the poster showcased ongoing efforts within the Defense Health Agency to install surgical smoke evacuation policies across 700+ military treatment centers. It reflected how cohesive policy efforts can push for change across distinct healthcare landscapes. Registered nurses, often the main advocates for establishing safer practices, and pushing for legislative action, possess a pivotal role in this mission.
Lastly, the poster bridged clinical evidence with ethical and policy concerns advancing an argument for uniform safety measures across geographies. It spotlighted the role of nurse advocacy in shaping safe perioperative environments and driving sustained enhancements in occupational health standards.