Making Operating Rooms Safe — For Employees
By Tracey Ybarra, Special to the Van Nuys News Press
Healthcare providers and hospital administrators dedicate their lives to providing health and healing to patients. Safe patient care is at the top of all healthcare initiatives, which might lead one to believe that a hospital would also be one of the healthiest places to work — but for operating room staff across the country, the presence of uncontrolled surgical smoke actually makes working in a hospital quite dangerous.
As an operating room manager with over 13 years of experience as a Perioperative nurse, I’ve breathed in my share of surgical smoke. This smoke, also referred to as plume, is caused by heat-producing devices used in surgery to stop the flow of blood or cut through tissue.
Being an advocate for health, I researched the dangers of regularly breathing in surgical smoke and found evidence that surgical smoke is not harmless: It contains over 150 chemicals, 16 of which the EPA classifies as priority pollutants and some which are identified as toxic carcinogens. The surgical smoke produced in an operating room each day can amount to the equivalent of smoking between 27 and 30 cigarettes with particles small enough to penetrate surgical masks. According to the Occupational Safety and Health Administration, an estimated 500,000 workers are exposed to surgical smoke each year.
As a reminder, this happens in hospitals.
It’s important for hospital administrators and governmental agencies to understand the health hazards these operating room staff are exposed to on a regular basis. If they heed the warnings, not only will they have healthier employees, fewer callouts and better morale, but the hospital will validate to its employees how important they are to the organization.
While technology to remove this smoke from the operating room has been around for a while, it hasn’t removed the smoke at the source or been user-friendly for the surgeon to use. Good surgeons perform surgery the same way, every time. So any solution to evacuate surgical smoke needs to be one that doesn’t require them to significantly change their current practice.
The good news is that the technology for removing surgical smoke has vastly improved, and can now properly remove smoke at the source. At Valley Presbyterian Hospital in Van Nuys, we’ve adopted a tool called the E-SEP Smoke Evacuation Pencil, which is similar to the pencils surgeons are accustomed to using. Now that the technology is available, it’s imperative to incorporate the removal of surgical smoke into our best-practice model.
Despite the improved technology, there are no federal or state regulations regarding the removal of surgical smoke in the operating room, and the U.S. lags behind Canada and other countries in mandating its removal.
If we don’t allow smoke in a restaurant, workplace or public park, then we shouldn’t allow it in an operating room. As we’ve become more aware of the risks of cigarette smoke, we have adapted to prevent secondhand consumption. Now that we are aware of the risks of surgical smoke, we need to adapt to ensuring the proper evacuation of it.
Now is the time to take care of caregivers and take the hazards of surgical smoke seriously. The state of California Legislature is on track to be the first state to pioneer this health safety measure by proposing Assembly Bill 402 which, if passed, will mandate efficient removal of surgical smoke from the operating room. It will be a life-changing bill — for those who spend their workdays in the surgical environment.
Valley Presbyterian already supports smoke evacuation procedures even without a mandate. Other hospitals would do well to adopt similar standards for their employees’ health — after all, it’s hard for a hospital to say it values excellent healthcare if it doesn’t care for the health of its employees.
Tracey Ybarra is a registered nurse and Perioperative Manager at Valley Presbyterian Hospital in Van Nuys, CA.