On Jan. 11, 1964, the U.S. Surgeon General, Dr. Luther L. Terry, issued the first report stating tobacco smoke causes cancer. His conclusion was based on over 7,000 published reports and studies on the correlation of smoking and disease causation. This groundbreaking report caused a ripple effect that continues today. By building on that research and the work of many others, it has been determined that smoke of any kind is hazardous to the health of humans.
We know that smoke is bad for us, and yet, we continue to accept smoke in the operating room. We do not accept smoke in places where we eat or go for entertainment, so why should we accept it in our workplace?
Smoke evacuators have been around for decades. I remember having an old vacuum for industrial use as a smoke evacuator when I first became an OR nurse. I know now that it simply did not protect us from the effects of smoke but rather, circulated it around the room for us to breathe in throughout the case. It was big, bulky and loud. We hated to use it, because you could not hear anything over the noise of the vacuum.
Modern smoke evacuators have come a long way from those old days. They are sleek, easy to operate, quiet and, most importantly, they are effective filtration devices. There are a variety of evacuators on the market that range from low cost efficiency units to more costly, computer controlled machines that can be used for open tubing, smoke evacuation ESU pencils and even laparoscopic procedures.
What features do you want to look for in a smoke evacuator? First of all, simplicity. The easier it is for staff and surgeons to use, the more likely they are to use it. Next should be replaceable filters that the staff can change. It should have Ultra Low Penetrating Air filtration. This is described as being able to filter to 0.1 microns at 99.999 percent efficiency. The smoke evacuator should also have an indicator to let staff know when it is due for a filter change.
To choose the proper device for your needs, first determine what types of procedures are being performed in your facility. If you are doing routine open procedures that generate a small to moderate amount of plume, you may want to select an economical, smaller evacuator. If you perform large, tissue reduction procedures such as panniculectomy or breast reductions, laser resurfacing or other procedures that produce large amounts of plume, you may want to select a more robust system that can capture large amounts of plume. If your facility does a variety of procedures that cover a broad range as well as laparoscopic procedures, you may want to consider a system that has multiple modalities including a laparoscopic mode.
All three types of devices offer advantages and an all-inclusive device will cover all of the procedures that you perform. While a device of this type may be a little more expensive, it will pay off in compliance as staff will only need to become proficient on one type of smoke evacuator and its functions. This allows the OR personnel to focus more time on patient care and not worrying about how different machines function.
Selection of the best smoke evacuator for your facility is key to compliance.
