WAGD systems used for smoke removal in OR

  • Wednesday, June 01, 2022 10:10 AM
    Message # 12801412

    The states of Georgia (SB 573 - https://openstates.org/ga/bills/2021_22/SB573/) and Connecticut (SB 89 under HB 5500 - https://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=HB05500&which_year=2022) have recently adopted legislation that requires all healthcare facilities "to utilize surgical smoke evacuation systems during surgical procedures to protect patients and health care workers from the hazards of surgical smoke."  I believe many facilities are planning to use the WAGD system to accomplish this, or to help meet this new requirement.  


    What are the potential dangers in utilizing the WAGD inlets to evacuate surgical smoke?  Reference 5.1.14.1.4 prohibits using WAGD systems for "non-medical applications" and the related annex material, A5.1.14.1.4 lists laser plume as one of the prohibited uses.  Most of the facilities in question utilize a combined medical vacuum / WAGD central supply system as well.

    Last modified: Wednesday, June 01, 2022 11:55 AM | Cary Darden
  • Wednesday, June 01, 2022 10:26 AM
    Reply # 12801468 on 12801412

    I found a comment by Mark Allen from the NFPA 99 2005 edition report on proposals that states the following:


    Proposal 99-225 Log # 70

    There is occasional interest in mixing WAGD and laser plume evacuation into the same system. Multiple uses of this type are potentially hazardous, particularly as the two applications have very different technical requirements, limitations on use and occupational risks to the maintenance workers.


    Mark, do you still have any of the data showing how / why this is potentially hazardous?  

  • Wednesday, June 01, 2022 11:53 AM
    Reply # 12801659 on 12801412

    Upon further reading I see within Chapter 9 that there is a section on Medical Plume Evacuation (ref. 9.3.8 from NFPA 99 - 2018) and there is associated annex material that further recommends against using WAGD for this type of smoke evacuation:


    A.9.3.8.1 Inlets can be of any design suitable for the plume

    capture device in use, provided the design does not permit

    interconnection to any medical vacuum, WAGD, or housekeeping

    vacuum systems.


  • Monday, June 13, 2022 1:02 PM
    Reply # 12815250 on 12801412

    Smoke plume evacuation produces a lot of debris that is sucked into the smoke plume evacuation system. The waste anesthesia gas disposal piping is not designed for any debris to be introduced into the piping system.

    The use of a WAGD piping system for smoke plume evacuation is not a good idea.

  • Tuesday, June 14, 2022 6:45 AM
    Reply # 12816029 on 12801412

    Cary,

    Sorry, but the notification system seems to have failed me and I only saw your post today.

    Bob K. has it right.  The problem with plume into WAGD is three fold:

    1. it contains "stuff" (droplets, particles, etc) which will collect in the pipe, particularly at elbows and tees and block up the piping. It seems to form a particularly nasty goop every bit as bad or worse than the stuff we find in medical vacuum when the clinical staff is not attentive to the collecting bottles.

    Theoretically, this can be dealt with using a point of use filter, but that MUST be done. Since we know that this is not always the case...

    2. different plume extraction techniques use different flows, but some are little more than a hood at the surgical site powered by a glorified shop vac.  No standard WAGD terminal can attain enough flow. Then they are proposing to split it?  

    Unless the WAGD system was designed expressly for the flow, the plume evacuation may overwhelm the system, resulting in unsatisfactory WAGD AND unsatisfactory Plume evacuation too.  Now in trying to solve one you now have two occupational safety concerns.

    3. Many of our WAGD systems are dual use, meaning that you are really using the medical vacuum system with a purple inlet.  Introducing plume into that system means that all these evils are now going to be visited on the medical vacuum, meaning now you have unsatisfactory WAGD and unsatisfactory Plume evacuation AND unsatisfactory medical vacuum plus the risk of blocking up your medical vacuum pipelines with the "stuff" previously mentioned.


    BTW, there is a new standard for Plume coming out I think this fall.  The revised ISO 16571 should be approved in July.  The current 16571 is pretty poor so don't waste your money, but the revision will be worth having.


    While Plume is not medical gas, this might be a subject for a MGPHO talk?  The Chair of the ISO 16571 group might be willing to do a review, and one of the members from Canada is a nurse with great expertise in the matter.  

    Last modified: Tuesday, June 14, 2022 6:49 AM | Mark Allen
  • Wednesday, June 15, 2022 12:18 PM
    Reply # 12817580 on 12801412

    Excellent information, thank you Bob and Mark!

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