Guideline for Surgical Smoke Safety

The revised AORN Guideline for Surgical Smoke Safety provides updated recommendations to support perioperative teams in reducing exposure to surgical smoke hazards and establishing a safe environment for patients and personnel. This guideline also marks its transition into AORN’s Living Guidelines model, which combines ongoing evidence surveillance with a structured process for evaluating whether new evidence warrants updates to recommendations. The guideline emphasizes a comprehensive surgical smoke safety program that incorporates risk assessment, application of the hierarchy of controls, effective smoke evacuation and filtration practices, respiratory protection when indicated, education, policy development, and ongoing quality improvement. 

Key Updates in This Revision 

• Reorganized the guideline around a comprehensive surgical smoke safety program. 
• Added stronger emphasis on risk assessment and procedure-specific planning. 
• Reinforced source capture and filtration as the preferred method of exposure control. 
• Clarified that room ventilation does not replace source evacuation and filtration. 
• Expanded guidance on smoke evacuation equipment, accessories, filters, and troubleshooting. 
• Clarified that respiratory protection is secondary protection and does not replace effective smoke evacuation. 
• Updated recommendations related to equipment selection and interdisciplinary evaluation. 
• Enhanced guidance for policies and procedures, education, and competency verification. 
• Expanded quality monitoring, compliance assessment, and implementation strategies. 
• Added greater focus on identifying and addressing implementation barriers. 

The public comment period closes September 12, 2026. Comments received after this date will not be considered in the final review.