Ready or not – surgical smoke mandates are here

State surgical smoke mandates are reshaping how hospitals think about OR air quality, and the Flamingo Funnel™ is built to make compliance hands-free, effective, and sustainable. As more states require smoke evacuation for every plume-generating case, “nice to have” has officially become “must have.” 

The rise of smoke evacuation laws

Over the past few years, state lawmakers have moved aggressively to protect perioperative teams from surgical smoke by requiring facilities to evacuate plume at the source. As of 2025, roughly twenty states—including Arizona, California, Colorado, Illinois, Kentucky, Louisiana, Minnesota, Missouri, New Jersey, New York, Ohio, Oregon, Rhode Island, Virginia, Washington, West Virginia and others—have enacted laws that mandate smoke evacuation in hospitals and ambulatory surgery centers. 

These laws generally require policies and technology that prevent staff from breathing hazardous smoke during any procedure “likely to generate surgical smoke.”

Make sure to visit AORN for the latest surgical smoke evacuation legislation guidance.

What the mandates actually require

Although each statute is worded differently, the core expectations look similar across states. Common requirements include: 

• Written policies to filter and evacuate surgical smoke for all plume-generating procedures in ORs and ASCs.
• Use of smoke evacuation systems or accessories that capture plume at or near the surgical site, not just general room ventilation.
• Implementation by a specified date (often phased in over 1–3 years) with ongoing maintenance and staff training. 

Failure to comply can bring survey findings, fines, or licensure and accreditation risk, so facilities need solutions that are simple to standardize across every room and service line. 

Why hands-free source capture fits the rules

Mandates are technology-neutral, but they all emphasize effective removal of surgical smoke without compromising safety or workflow. Traditional handheld smoke-evacuation pencils can technically meet the requirement, yet they compete with instruments for space, add cords, and rely on perfect human compliance every minute of every case.  Additionally, they also impact surgeon visualization and dexterity. Hands-free source capture, by contrast, keeps the smoke capture device positioned right at the incision so smoke is removed continuously while surgeons work as usual. 

This approach aligns closely with professional guidance from AORN and others, which stress capturing smoke as close as possible to the point of generation to protect staff from fine particles, chemicals, and bioaerosols. 

What facilities should do next

For hospitals and ASCs, staying ahead of state mandates starts with understanding current and pending legislation, then choosing solutions that staff will use every time. Practical steps include: 

• Checking the latest AORN legislative map and state hospital association updates to confirm effective dates and scope in your state.
• Standardizing a smoke evacuation policy that identifies preference and rationale for choice of smoke capture solutions, based on multiple factors including level of plume produced, need for dexterity and visualization, and surgeon preference.
• Evaluating devices like the Flamingo Funnel in real OR workflows to confirm that they meet both your clinical expectations and your compliance requirements.

As the map fills in and more states go “smoke-free OR,” facilities that invest now in intuitive, hands-free capture will be better positioned to protect staff, satisfy inspectors, and keep cases moving smoothly—all while making surgical smoke a problem of the past rather than a daily exposure risk. 

Need more guidance on best practices for an evaluation? Download our OR smoke capture compliance evaluation toolkit today!