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The Gold Standard of Smoke-Free Surgery
When a nurse had an asthma attack following a plume-generating surgery, our perioperative team sprang into action.
Beata Mastalerz, DNP, RN, NEA-BC, CNOR
Publish Date: June 9, 2022   |  Tags:   Staff Safety Patient Safety Workplace Culture
GOING FOR GOLD Because of the effort it made to go smoke-free in the OR, the Manhattan Eye, Ear & Throat Hospital was awarded AORN’s Go Clear Award in 2022.   |   Beata Mastalerz

The decision to rid our facility of surgical smoke occurred when one of our perioperative nurses became consumed with plumes emitted into the OR air from the use of electrosurgical cautery. The team in the room was in the middle of a breast-reduction surgery, a high smoke-generating procedure. After a few minutes working the case, the nurse began experiencing asthma-like symptoms. Her difficulty in breathing required an immediate intervention and the symptoms subsided only after 30 minutes of treatment in the PACU.

To protect the veteran nurse, who has a history of respiratory challenges triggered by smoke and other noxious fumes, our short-term goal was to assign her to cases that don’t generate a lot of surgical smoke. Of course, as any surgical leader can attest, you can’t always control staff assignments on such a granular level. Still, there was absolutely no doubt she reacted negatively to surgical smoke, and we knew additional actions needed to be taken to protect her from further exposure and harm.

Looking back, having to treat a stricken member of our team in the PACU was the starting point of our journey to smoke-free ORs. An effort championed by the very nurse who suffered the severe asthma attack served as a catalyst and eventually led us to where we are today: Proud recipients of AORN’s Go Clear Award at the gold level, the highest of three designations that recognize standout healthcare facilities that have implemented practices and protocols to eliminate or greatly reduce surgical smoke. The Go Clear program requires facilities to meet 10 components, which include developing an action plan for smoke evacuation and education for staff. When facilities meet the requirements, they’re judged on their education performance, smoke evacuation compliance and having a sufficient number of smoke evacuators available for use.

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