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Surgical Plume Hazards — FRCA Final MCQ

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ModerateAnaesthetic Equipment & SafetySurgical Plume HazardsFRCA Final

A 42-year-old man (ASA I) is having a tonsillectomy. The surgeon uses monopolar diathermy on a high coagulation setting. What gas is produced when diathermy is used on tissue, and what is the main hazard?

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Correct answer: D — Surgical plume containing carcinogens, viable virus particles, and irritants – risk of respiratory harm

Surgical diathermy/electrocautery produces surgical plume (smoke) containing >80 chemical compounds including: benzene, hydrogen cyanide, formaldehyde, and polyaromatic hydrocarbons (carcinogens), as well as viable bacteria and virus particles (including HPV and HIV). The plume is equivalent to cigarette smoke in toxicity. All operating theatre personnel are at risk of respiratory harm. Prevention: local exhaust ventilation (smoke evacuators), appropriate theatre ventilation (20 air changes/hour), and laser-grade masks (standard surgical masks are inadequate for viral particles).

Reference: AAGBI – 2020 – Safety in operating theatres; HSE – 2021 – Surgical plume guidance