A departmental audit of clinical use of N2O can be helpful on multiple fronts. It allows comparison between procurement and clinical use, with any discrepancies helping identify leaks within the N2O infrastructure. It also allows for understanding of N2O clinical use patterns within the department to help focus interventions to help reduce clinical use of…
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Kn2oW Nitrous Steps
Climate change is a problem for us all to tackle. As the guardians of inhaled anaesthetics Anaesthetists have a major role to play in reducing health system emissions due to N2O. The Kn2oW Nitrous campaign hopes to empower people to take a closer look at N2O consumption in their hospital with the aim of reducing…
Leaks
Leaks are a major source of Nitrous Oxide emissions. As such the UK and Ireland Anaesthesia bodies have recommended decommissioning of nitrous oxide pipelines by 2026/27 and moving to nitrous oxide provision at point of care by cylinders. The Australian Health Care Facilities Guidelines were updated in 2024 and now suggest Nitrous Oxide should not…
N2O Clinical Use Generic Survey
Below is a generic survey that assesses use and attitudes to N2O. Feel free to adapt to your own department. Demographics State: Service: Hospital: Consultant or trainee (What level are you if you are a trainee?): Amount used How many times in the last year have you used nitrous oxide? Never once 2-5 6-10 >10…
Anaesthetic Machine Reported Nitrous Usage
Interrogating Anaesthetic machine logs can give a clear picture of N2O usage by a given machine. The cumulative gas usage can be reset and then periodically reviewed to allow clear consumption data, per anaesthetic machine, for a given period. The way to detect N2O consumption from 2 popular anaesthetic machines is outlined below. GE Aysis…
Nitrous Oxide Pipeline Test Protocol
Several hospitals in Australia have demonstrated large leaks of nitrous oxide that were not detected by the routine inspections required by Section 6 of Australian Standard 2896:2021. As N2O is a schedule 4 drug and significant greenhouse gas, any such leakage is unacceptable. There are two ways to detect a leak: monitor pressure or weight…
Recycling Streams in Theatre
Operating theatres produce 20-33% of total hospital waste, including up to 60% of the hospitals’ regulated medical waste. Ensuring we reduce, reuse and recycle where possible can have a substantial impact on costs ($ and eCO2) and waste. An example of streams that are easy to recycle in a tertiary hospital is available on the…
Greening Surgical Care
A recent article in the Journal of Climate Change and Health by Asfaw et al from the Cleavland Clinic has given us some ideas which we’ve synthesised into the below table for easy digestion! What ideas do you have to add? Tell us on twitter SUMMARY POINT PRIMARY DRIVER CHANGE IDEAS HVAC ‘setback’ Reduce energy…
Where does the Green Theatre Network Fit in?
GTN aims to provide a network for Green Theatre Groups at each hospital to collaborate. The GTN can then provide a statewide advocacy to a variety of bodies including state health departments, professional bodies and other related organisations. The Green Theatre Groups at each hospital provide an opportunity for multidisciplinary staff and hospital leaders to…
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