Nitrous Oxide mitigation
Nitrous oxide use is widespread outside anaesthesia – ED, labour ward and burns wards frequently use it. Particularly in older hospitals, outdated and poorly maintained pipeline infrastructure can mean more nitrous leaks into the atmosphere than goes into patients. A great place to start learning more and designing a nitrous oxide mitigation project for your centre is at https://anaesthetists.org/Home/Resources-publications/Environment/Nitrous-oxide-project
We probably can’t get rid of it entirely – it’s just too useful – but we can help identify and fix massive wastages of this potent greenhouse gas.
Peri-operative MDI use – transitioning away
Work with preoperative clinics and the holding bay staff to encourage patients to see their GP to optimise asthma therapy with long-acting agents, to bring their own MDI devices (to avoid using new MDIs) or using nebulised medications driven with medical air where available.
Liaise with your pharmacy department to explore ordering more environmentally friendly powdered inhalers for routine use on the wards in place of MDI, and link in with your Respiratory Medicine department to endorse guidelines for preoperative optimisation of asthma therapy.
Making conferences closer to carbon-neutral
We can make individual contributions to carbon offsetting, however we all attend conferences which through travel, food and accommodation, and impact on local ecosystems, have an associated significant carbon cost. Lobby your college to introduce mandatory carbon offsetting for conferences with an option for college members to contribute, or build it into the cost of the conference.
Take a leadership role
Nothing gets done in large organisations without data – partner with your pathology department to quantify pathology tests done in certain high-volume areas, such as ICU, ED and preoperative clinics, and their associated costs. You might be surprised how much duplication and unnecessary tests are done based on the Choosing Wisely principles available at https://www.choosingwisely.org.au/recommendations?q=&organisation=&medicineBranch=&medicalTest=2786&medicineTreatment=&conditionSymptom=
Use this data to create a guideline for all staff – and re-audit to determine both reduction in tests done and costs. This is a great project to demonstrate that sustainability actions can also produce net savings for the health service while maintaining high standards of care