A practical checklist for laser safety in operating and procedure rooms

Laser systems used in operating and procedure rooms are high-energy devices that can create multiple concurrent hazards, including direct and reflected beam exposure, eye injury, surgical smoke exposure, and fires in oxygen-enriched environments.Although many institutions maintain laser policies, gaps persist between theoretical wavelength-specific risk information and the moment-to-moment decisions made by surgical teams.This narrative review synthesizes major safety standards and clinical guidance, differentiating itself from traditional guidelines by explicitly converting physical hazard data into a practical, workflow-oriented checklist.The framework emphasizes the role of foundational laser safety program elements, plume and surgical smoke control, fire prevention, protective eyewear, reflection control, and emergency response protocols.A central contribution to this framework is a "translation layer" that maps wavelength bands and delivery platforms to actionable control points across perioperative phases.To enhance clinical usability, the dispersed safety steps are consolidated into a comprehensive checklist, and specialty-specific clinical scenarios illustrating potential hazards are discussed.Key priorities include defining the nominal hazard zone, enforcing the use of optical-density eyewear, and standardizing emergency responses, such as airway fire management.