Bovie Smoke

Specialties Operating Room

Published

I just got the newest edition of Alexander's as part of a 125 hour CE course (to renew my CNOR.)

OK, so I was reading about laser plume . It says that exposure to laser plume during long cases equates to smoking either 2 or4 (can't remember which) unfiltered cigarettes.

Well,we usually use a smoke evac anyway.

But then it goes on to say that bovie smoke--during one long(didn't say how long,but in previous topics they equated "long" to "in excess of 2 hours--") IS EQUAL TO SMOKING 6 UNFILTERED CIGARETTES!!!

OK, I know that off and on over the years we kinda made half-a**ed attempts to suction bovie smoke, or assign the R1or R2 that role so he had something to do with his hands--

But I have NEVER worked anywhere where we hooked up a smoke evac, (except for laser--and that was usually because we were scared of aerolization during vaporization of condyloma) or had those special bovies with the suction tubing built in--

6 unfiltered cigarettes per case, huh? For me, over 25 plus years, that's--

HEY!!! So THAT's why I have had SOB lately!!--

And here I was just figuring I was out of shape and needed to start going to the gym more often--

Here's me in 5 years: old GOMER with COPD in VA hospital, trailing my O2 tank, wheezing--never smoked a cigarette in my life--

What do you guys think of this? I did not see what research study came up with these figures, (6 unfiltered cigarettes) but I will explore further---if this is accurate, I can't imagine why OR nurses across the US do not have emphysema in epidemic proportions---

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Specializes in surgical, emergency.

Speaking as a 20 year vet of surgery, I can't believe that we have not seen this problem, as a problem, until the last few years or so. At least we really haven't talked about this before. Have you ever stood at the foot of the bed and watched the bovie smoke rise from the wound, right into the faces of the surgeons and our co-workers!!!

Many have noted minor respiratory/allergy/eye irritation problems over the years.

We recently did a trial of some smoke evacuators. After the trial was over, some of the docs that were the most vocal about being required to try the evacuators, were the first ones to ask when we were getting them!!

hummmm :wink2:

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G'day All,

While I'm not sure what "bovie smoke" is, surgical plume from diathermy has been known to carry viral microoganisms, such as those causing the anal warts you excised yesterday.... it sounds like a really good incentive to follow "universal" precautions and use a smoke evacuator in every case, not just the viral risk cases. We've trialled ones that clip onto the diathermy pencil that seem to work fine, although I've heard recently that our standard wall suction is considered insufficient for smoke evacuation.

Weird.

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Greetings! I'm new to the O.R. (8 weeks) but I've already become very concerned about the risks of electrosurigical smoke and the seeming lack of concern by almost everyone I have spoke with! Many shrug their shoulders and say the surgeons thought the smoke evacuators were too noisy and cumbersome to hold, etc. I truly feel I'm the only one in the entire O.R. that is worried about this. At least, it feels that way as I never hear anyone discussing it. Like Stevierae, I'm also planning on doing more "research on the research" and see what comes up. Let's keep discussing this most important subject!

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G'day All,

Today I had a combined diathermy / smoke evacuator pencil, disposable, sleek, quiet and effective. I loved it! If only more surgeons used the things, rather than stuffing around with evacuators only on "viral risk" cases... as if we could really tell. I don't smoke, try to stay away from smokers, but still breathe diathermy and laser plume with no choice in the matter. Sounds like a court case waiting to happen.

Welcome to theatres, and the forums, Lunamara. Sea of the moon... I love it and your symbol, very zen.

Adiau, people...

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Specializes in surgical, emergency.

Getting rid of Laser/ESU plume in our OR seems to be becoming my life's goal.

Lunamara, you have good reason to fear inhaling all that smoke. Just go do a lit. search, and you will find all kinds of things in that plume.

Sometimes in the OR, we tend to live and support "sacred cows", doing things because that's the way that it's always done. ESU/laser plume needs to be addressed. Unfortunately, it will probably take some federal act to get people moving.

Nothing like the thought of OSHA coming in swinging the big sword to stimulate some action! :chuckle

By the way, if anyone is interested. After trying 3 or 4 units, we found the Crystal Vision unit, from DeRoyal to be the one we liked.

It was quiet, and was able to perform several different applications.

The funny thing, after we finished our trials, the surgeons who were the first to notice the evacuators were gone (and wanted them back) were the ones that whined the most when we started the trials. Go figure.

Mike

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We use a smoke evacuator for all cases, except for laporscopic cases. That wasn't the case when I first started there 3 1/2 years ago. Whenever someone forgets to hook up the "hoover" everyone notices right away, and you immediately turn it on. The smell of cautery is really offensive now and no one willingly tolerates it anymore.

Ruby

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I started working in my OR in September and noticed without exception that we use a smoke-evac on all our cases. Apparently some Dr's *****ed pretty heavily but due to our supervisors previous experiences we rarely make exception. (Apparently she and another scrub formed condylomas on their eyelids after a condyloma removal case which the hospital paid to have removed). Those doctors now have slimmer (but more expensive) smoke evacs

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I shadowed today in the OR and decided to do a search on this subject. As I was standing there watching the circulator on the computer.....this awful smell engulfed the room. That's when I noticed the plume that looked like a campfire I had this last summer. I asked if they had an evacuation system and I got a "look" and was told no. This seriously bothers me. But, anyway I just wanted to bring this thread up to date and see what everyone else thought! There has got to be some rule for mandatory evacuators put in place before it's too late.

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Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

We use smoke evacs on all cases with a bovie. As one surgeon puts it: "I don't smoke. Cigarettes or burning tissue."

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On again with bovie smoke, I noticed that I posted on this thread over a year ago. Bovie smoke is a known carcinogenic. If you have concerns about this in your O.R. you could try raising this as an "occupational health and safety" issue in your workplace. If you are in the U.S. and not unionized try going through a state agency related to workplace health and safety. The facts are out there, and the equipment is out there too. We use "Valley Lab" equipment, and I am sure that any of the companies that sell smoke evacuators can help you by providing literature on this subject. Also try and get literature from A.O.R.N. or O.R.N.A.C. as I am sure the must have postion statements on this issue. If you push it a little bit maybe you will get some support on this very important issue.

Good luck, P65

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Yes, it's an old post, but a very astute observation by a nursing student! We don't use smoke-evac bovies for most of our cases, but I've never seen the amt of smoke described, either. Some surgoens will request them for the types of cases where they know they will be using a lot of cautery. On the other hand, we do "cover up" a certain amt of plume at time by suctioning it which really doesn't solve anything! I did once work in an OR (veterinary) that used a scavenger system over the table but in that case the OR didn't have adequate air exchanges so it was quite needed!

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