In early June 2018, Rhode Island Governor Gina Raimonda signed legislation that requires operating rooms throughout the state to adopt policies to eliminate surgical smoke via smoke evacuation systems. When the law takes effect on Jan. 1, 2019, Rhode Island will be the first state to adopt such a law.
Surgical smoke evacuation has been a topic of discussion for years. The law, which represents the first major step in protecting both patients and hospital staff against the dangers of surgical smoke, was passed with the support of the Association of Perioperative Nurses (AORN). The organization has advocated for smoke evacuation for more than 20 years.
Like a pack-and-a-half of Camels
The average daily impact of surgical smoke on the OR team is equivalent to 27 to 30 unfiltered cigarettes. Chemical, viral, bacterial, and blood particles can live in surgical smoke for up to 72 hours, posing harmful effects both to the surgical staff and to patients. There are four documented cases where surgical staff contracted HPV in their upper respiratory system from smoke, along with numerous reports of respiratory illnesses caused by exposure to plume.
For the patient, smoke migrates through the peritoneal membrane and decreases the oxygen-carrying capacity of red blood cells. For a young, healthy patient this does not pose a serious risk, but in a critical case, this could be catastrophic; it also alters the readings on the pulseoximeter used by the anesthesiologist.
A big step in the smallest state
Despite these concerns, 49% of respondents to a National Institute for Occupational Safety and Health (NIOSH) survey reported never having received any training on the hazards of surgical smoke. The legislation in Rhode Island is the first step in clearing operating rooms of the hazards of surgical smoke across the United States.
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