UK and Ireland Anaesthesia bodies have recommended nitrous pipelines be decommissioned and cylinders used in lieu. USA and Australian health services are following suit. This is because hospitals with piped nitrous oxide repeatedly demonstrate around 95% of nitrous oxide purchased never reaches a patient due to leaks1.
But what specifications to put in place for your new hospital build? Here are some resources which support the omission of piped nitrous oxide from new hospital builds. The clinical delivery of nitrous oxide can be achieved by cylinders at the point of care, where required.
Medical gas systems are expensive to install and maintain, by avoiding to install these systems this capital and ongoing cost is avoided. Hospitals in Australia have reported annual maintenance costs for a nitrous oxide pipeline servicing a theatre suite to be around $8000-$20,000 per annum depending on the theatre size. A manifold (replacement) has been estimated to cost around $20,000. In addition gas suppliers charge rental fees for manifold cylinders.
Spencer N et al. NHS Lothian nitrous mitigation project: assessing nitrous oxide usage at a district general hospital. Anaesthesia. 2021; 76(6): 24. Wise J. Creating more sustainable practice: the NHS clinical teams innovating for a greener future. BMJ. 2021; 375: 1-3. ↩︎
