• Quiet, please. Smoke evacuator manufacturers have made great
strides in this area in recent years. The latest devices are a lot quieter
than they used to be. If your machines are so noisy that they distract
attention from OR communication, or that they go unused, they
should be replaced. Settings that automatically turn the suction on
and off with electrosurgery and laser use so they're not running con-
tinuously are also a big benefit.
• Efficient action. Ultra-low-penetration air (ULPA) filters are standard
in smoke evacuators. They're designed to capture 99.999% of airborne
particles (that is, 1 in 1 million particles escapes). But be sure that the
suction pulls effectively. Is it immediately active, or does it miss some
of the plume as the smoke evacuator ramps up?
• Convenience and control. You could purchase the most advanced smoke
evacuator on the market, but without buy-in from frontline users, it
won't be routinely used. Most physicians are satisfied by a suction
handpiece that fits in their hand, that doesn't interfere with their tech-
nique or obstruct their view, and that activates easily when needed. A
system that sets up easily, that signals when filter life is low, and that
doesn't make filter changes difficult, often wins staff approval.
• Is portability a plus? While mobility is a benefit, keep in mind that you
shouldn't have to move a smoke evacuator from room to room. You
should have one stationed in every OR. Otherwise, there's a risk it'll
seem like too much trouble to retrieve the equipment from another
room for a smoke-generating procedure, and safer practices will
remain out of reach.
OSM
Dr. Ball (kayball@aol.com) is an associate professor of nursing at Otterbein
University in Westerville, Ohio, a nurse educator, and a consultant who
chaired AORN's Surgical Smoke Evacuation Task Force.
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