Below is a generic survey that assesses use and attitudes to N2O. Feel free to adapt to your own department.
Consultant or trainee (What level are you if you are a trainee?):
How many times in the last year have you used nitrous oxide?
>10 (please provide rough estimate):
In what situations do you consider using Nitrous oxide?
Paediatric gas inductions
Maintenance of anaesthesia
Adult gas inductions
Stimulating parts of procedure
IV cannula placement
During regional anaesthesia
Attitudes to Nitrous
What clinical benefits of nitrous oxide influence your decision to use it?
Do you believe medical Nitrous Oxide is a significant source of health care associated carbon emissions?
Do you think your department would benefit from further education on the environmental impacts of nitrous oxide?
Would you consider decommissioning piped nitrous oxide infrastructure? (For non-obstetric or paediatric hospitals.)
Do you have any suggestions for ways to reduce emissions from medical Nitrous Oxide?