Putting anaesthetic-generated emissions to bed

The issue

Across the NHS, anaesthetic gases are commonly used as a part of everyday surgeries. These gases alone, along with analgesic gases like nitrous oxide, are responsible for over around 2% of all NHS emissions.

Amongst anaesthetic gases, desflurane is one of the most common, but also one of the most harmful. It has 20 times the environmental impact of other less harmful greenhouse gases and using a bottle has the same global warming effect as burning 440 kg of coal.

2% of the NHS carbon footprint comes from anaesthetic and analgesic practices. The NHS Long Term plan commits to lowering this by 40% by “transforming anaesthetic practices” such as using alternatives to desflurane.

The solution

Recognising the impact climate change is having on the environment and the health of its people, University Hospitals Bristol and Weston NHS Foundation Trust has stepped up activity.

In addition to committing to take actions against single-use plastics, recycling, waste disposal, staff vehicle emissions and more, the trust sought to address the impact of anaesthetic gases.

The trust have been encouraging the use of alternative surgical anaesthesia options to reduce the use of desflurane, such as switching to lower carbon alternative sevoflurane.

Staff at the trust have been supporting colleagues in using less harmful gases, with positive results.

Anaesthetists Mat Molyneux and John Hickman developed several engagement tools to raise awareness and provide information. These included coloured prompt cards placed on anaesthetic machines with facts about the impact linked to everyday activities such as driving a car and QR codes on machines directing clinicians to website resources for more information.

To stimulate engagement and discussion, John and Mat created an interactive challenge for staff. Eight different prompt cards with short anagrams were developed which once solved revealed the statement ‘Consider the environmental and financial impact of volatile anaesthetics on future generations.’

The impact

In just two years, the staff at the trust have reduced use of carbon intensive desflurane significantly, saving the equivalent to 30,000kg CO2 per month.

Mat Molyneux, consultant anaesthetist at University Hospitals Bristol, said: “The monthly reduction when converted to carbon dioxide is equivalent to 166 cars off the road or 105,000 miles driven by an average passenger vehicle.”

On the trust’s wider sustainability plans, Sam Willitts, Head of Sustainability commented: “We’ve introduced a lot of initiatives to lead by example, but everyone has a part to play to help us achieve our sustainability plans. No action is too small. There are things we can all do whether at work or at home, from turning off computers or lights to looking at more sustainable ways of travelling such as using public transport or bicycles.”

Over to you!

Buoyed by the results of this project the trust has now initiated another project to reduce nitrous oxide waste and use. Nitrous oxide is a gas commonly used as an anaesthetic and analgesic agent that has an environmental impact 300 times that of carbon dioxide.

For more information about sustainability projects at University Hospitals Bristol and Weston NHS Foundation Trust: www.uhbristol.nhs.uk/about-us/sustainable-development/

Contact: Sustainability@UHBW.NHS.UK

Updated September 2021.