Ever hear of reactive airway disease? Bonnie Weinberg, MSN, RN,
CNOR, clinical practice specialist for the operating room at The Valley
Hospital in Ridgewood, N.J., says that a couple years ago, a surgeon at
her hospital complained of wheezing and some respiratory difficulty. He
visited a pulmonologist, who told him that he had reactive airway dis-
ease caused by something in his environment — which the surgeon
attributed to surgical smoke — and put him on an inhaler. Other nurses
also told Ms. Weinberg that they dreaded scrubbing in because of the
headaches and nasal congestion they would get after breathing in the
smoke. The hospital decided to make the move to smoke-free ORs,
spearheaded by the affected surgeon. "I said, 'Our campus is a smoke-
free environment, so why aren't our ORs smoke-free?'" says Ms.
Weinberg.
The surgeon worked with the other doctors in the facility to get them
on board, and the hospital trialed several different plume evacuation
pens. Ms. Weinberg says she also sat down with staff to explain the
implications of surgical smoke and worked with the vendor of the pens
to place posters around the facility reminding staff and surgeons about
the importance of evacuating surgical smoke. A year has passed since
the hospital began using the evacuators, and the surgeon tells Ms.
Weinberg that he now "rarely has to use his inhaler."
What's in it?
Researchers are still working to find a direct link between surgical
smoke and long-term health effects, but that doesn't mean facility
leaders are any less concerned. One survey respondent says she's con-
cerned about "the potential for long-term effects that may be insidious
in nature." "I'm sure it can't be healthy to be inhaling the plume of
smoke coming from using the cautery," adds another.
"I am concerned about the toxins, viruses and bacteria that can be
present in surgical smoke and the long-term effects that staff can
develop with repeated exposure," says Imelda Kelly, RN, CNOR, direc-
5 6
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | February 2015