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Green Theatres Network

Kn2oW Nitrous Steps

Posted on June 13, 2023

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 carbon emissions. To make things easier we have provided some simple steps to follow for anyone interested in tackling this issue in their own institution. Just contact the relevant person within your hospital and follow the steps provided

Engineering

N2O Pipeline Map

  • Ensure the map of N2O infrastructure is up to date and decommission any unused outlets or limbs. This will decrease the risk of leak from unnecessary piping.

System Assessment

  • Ensure that your hospital has a service contract to regularly assess piping infrastructure for leaks. Find out who does the checks and how frequently. In addition to following the Australian Standard, the system should be pressure tested. Click here for pressure testing protocol. 

N2O Manifold

  • Ascertain the size of the N2O manifold. If decommissioning is not possible consider downsizing the manifold so regular purchasing is needed. This decreases the cost of cylinder hire and enhances the detection of new leaks.

Finance or Gas Provider

Procurement Data

  • Determine the timing and amount of N2O procured by your hospital over the last 5 years.

Anaesthetic Department

Clinical Use Audit

  • Audit the clinical use of N2O within the department by consultant survey and interrogation of the anaesthetic machines. Determine if clinical use matches purchasing. Click here to go to our clinical audit page for more information.

Educations Sessions

  • Provide an education session for your department. Discuss the environmental impacts of N2O, findings of the clinical audit and potential strategies to reduce N2O use.

Decommission

  • Consider decommissioning the piped N2O system in adult only hospitals. Provide small portable cylinders to selected anaesthetic machines and portable entonox cylinders to be used as required.
  • kn2ow nitrous

Recent Posts

  • Recordings for GTN WA meeting online
  • Pearls from CAHA Forum 2023 Sustainability in Practice session
  • GTN Statewide Meeting August 2nd 2023
  • Ditching Desflurane
  • Nitrous Oxide Clinical Use Audit

Green Theatres Network WA Follow

Environmental sustainability for perioperative services across WA. https://t.co/wxD5hUoRKi #ditchthedes #reducereuserecycle

WAGreenTheatres
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archiecurium Dr Archie 🌱🌈 YES23 @archiecurium ·
14 Sep

Dear Aussie anaesthetic colleagues - @WAGreenTheatres team needs your input please on use of nitrous oxide. Takes 2min and will help us a lot.
Thank you!

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healthy_climate Climate and Health Alliance @healthy_climate ·
14 Sep

#GreenHealthForum23

Any clinicians who use nitrous dioxide -- please take this 2 minute survey to help us understand how you use it at work! 👉 https://forms.office.com/r/GrMxTGZdKy

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wagreentheatres Green Theatres Network WA @wagreentheatres ·
14 Sep

Australian anaesthetists, get involved with sustainability data collection on nitrous oxide. 2 minute survey, please complete it!

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archiecurium Dr Archie 🌱🌈 YES23 @archiecurium ·
13 Sep

Apropos of nothing
There are plenty of reasons to stop using desflurane.

One of them is environmental harm.
A little bit is still >0
Plenty of other ways to give a safe anaesthetic with less impact and no worse outcomes

@GreeningDoc

https://journals.lww.com/anesthesia-analgesia/fulltext/2020/10000/desflurane_should_des_appear__global_and_financial.43.aspx Meyer 2020

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