Surgical Plume

Surgical Plume

Last night I flew to Sydney to facilitate a workshop for the Operating Theatre Association of NSW. The issue was surgical plume, the smoke, particulates and other “stuff” that is released when laser equipment and other energy devices are used on human flesh in operating theatres.

I first came across the issue in Darwin at the end of May when I was facilitating at the ACORN Conference. ACORN is the Australian College of Operating Room Nurses, the peak body representing nurses who work in operating theatres.

What woke me up to surgical plume as a serious health issue was a presentation by Penny Smalley, a nurse consultant from the United States who is also a lecturer and trainer in the use of surgical laser equipment. To say Penny is passionate about this issue is an understatement. She is also recognised as one of the world’s leading experts on the issue.

Surgical plume is dangerous, just like smoking is dangerous as the plume contains many of the same chemicals and carcinogens that are to be found in cigarette smoke. Indeed, one relatively basic procedure using energy or laser devices in a theater gives off the same amount of smoke as three cigarettes!

Imagine then, what it’s like for theater nurses and surgeons who operate a long list on any given day in any Australian tertiary hospital.

There is copious amounts of anecdotal evidence that nurses are suffering the ill effects of surgical plume. Headaches, flu-like symptoms and other respiratory symptoms suffered by theatre nurses are now known to be caused by surgical plume.

So, if it is this harmful, there must be a solution to the problem and hospitals are doing something about it, yeah?

Yes, there are solutions; technical solutions involving filters, “pens”, wands and other bits of gear. Technical solutions that meet standards established around the world and which effectively deal with the problem.

But nurses still have an issue because some people – many of them surgeons – refuse to use the equipment. They cite obstruction of their view or it “doesn’t feel right” or a myriad of other excuses.

Some hospital administrators have no real idea of what goes on when those double doors close behind a surgical team and so it doesn’t appear on their radar as an issue that warrants urgent action.

A small group of nurses in Australia is working to change the culture in hospitals and create a safe working environment for their colleagues and those who work in an operating theatre. But there are many obstacles in the way. Apathy from many of their colleagues, resistance from surgeons, lack of real awareness by administrators and a reluctance by nurses themselves to take affirmative action and withdraw their services from what is an unsafe environment are the main ones.

The fact is, nurses and other healthcare workers are covered by the occupational health and safety laws of each state where employers are required by law to provide a safe working environment.  The problem is those double doors that separate the rest of the hospital from the operating theatre. What happens behind those double doors tends to stay there.

As someone who underwent two surgical procedures in the last 20 years, I feel reasonably certain that patients do not want the nurses who cared for them in their greatest hour of need to be exposed to hazards like surgical plume. It’s just that they don’t know about it. We, the patient, arrive in a state of angst and are swiftly put under by the “gas man” and the next thing we know we are in recovery.

I’ll post some links at then end of this blog where you can read up on surgical plume and enlighten yourself on the issue.

If, like me, you feel moved to do something about it, take some action. Call or e-mail your local state MP and ask him or her about surgical plume in your local hospitals. Unless they are a doctor or nurse, they probably won’t know about it. But your asking about it forces them to find out. Maybe then they will highlight the issue in Parliament.

As Australians we love our nurses. They look after us when we’re crook. We hate it when something threatens them. By the way, I’m a bit biased on this issue. I have three sisters, all of whom are nurses. They do great work. I want to keep them safe.

Surgical plume is one of those threats that can so easily be eliminated. Theatre nurses could use our support to help make that happen. Lend them your support and keep them healthy so they can keep you healthy when you need them most.


Penny Smalley:




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