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Focus on a solution
The complaints about smoke evacuators are generally predictable: They're loud.
They're distracting. They're too expensive. They're bulky. Surgeons don't like them or refuse to use them. Fortunately, as noted, technology is gaining ground, making the usual complaints easier to overcome. If you need to upgrade your smoke evacuation capabilities to keep staff and patients safe, there are several factors to consider, as spelled out by AORN guidelines.
A smoke evacuator is the best way to capture all surgical smoke. And efficiency is the primary consideration when evaluating options. The amount of smoke one can capture depends on its motor rating, the tubing size of the collection device, how close the collection tubing is to the site where smoke is generated, and the amount of smoke being created. Ideally the evacuator will
• be easy to use and quiet;
• have either a foot pedal to activate it or an automatic sensor that turns the unit on and off as smoke is created and evacuated;
• be easy to access and portable; and
• have an indicator (either a light or an alarm) that alerts you when the filter needs to be changed.
Ultra-low penetration air (ULPA) filters are much more effective than highefficiency particulate air (HEPA) filters for capturing tiny smoke particles, allowing only 1 in a million particles to escape. A good triple-filter system includes a pre-filter to capture large particles and fluid, a ULPA filter to capture small particulate matter and a charcoal filter that absorbs toxic gases and odors. Coconut-based charcoal filters are the most absorptive.
If you're dealing with very small amounts of smoke, you may be able to get by with only a wall suction unit. They're simple to use, but they move air less than 5 cubic feet per minute (compared to 25 to 50 for smoke evacuators). Keep in mind, it's extremely important to use in-line filters with wall suction and to keep them from getting clogged with smoke particulate matter. They need to be changed according to manufacturer recommendations and carefully disposed
