Anaesthetics
Elective and Emergency Anaesthesia
How is climate change affecting the delivery of anaesthetics?
Anaesthetists have a broad role, but generally they give strong medications to drift patients off to sleep whilst taking careful control of a patient's breathing and circulation.
Air pollution from cars and industry can make their job difficult. Air pollution can damage people's heart and lungs, contributing to illnesses like heart disease, asthma and lung cancers. Such conditions make surgeries tricky and increase the risk of complications.
Anaesthetists often deliver antibiotics during the surgery to reduce the risk of infection, a common side effect of surgery. Global warming is impacting on antibiotic resistance as some bacteria can live longer and grow faster in warmer temperatures, reducing antibiotic effectiveness. Over time, if antimicrobial resistance worsens due to climate change, it may be too risky to perform surgeries such as joint replacements.
How does Anaesthesia Affect Climate Change?
Anaesthetists often use gases as a way of drifting people off to sleep. These gases are highly polluting and have a large green-house effect.
For example, using the anaesthetic gas Desflurane for 1 hour, is the same as driving a car 320km (200 miles). All other anaesthetic gases used, such as nitrous oxide (entonox) and sevoflurane also have much bigger effect on global warming than carbon dioxide. These gases alone represent 5% of the carbon footprint for all acute NHS hospitals.
Alternatives with lower environmental impacts such as using intravenous anaesthetics (known as "TIVA"), or regional anaesthetic blocks can be just as safe for patients as anaesthetic gases, though each patient should have all factors taken into account.
A large proportion of equipment used by anaesthetists is single-use plastic. Depending on its type and use, it will either go to landfill or for incineration.
Additionally, if drugs are disposed of incorrectly, such as down a sink, they can run off into aquatic environments where they may have a cumulative effect on wildlife and biodiversity.
Royal College of Anaesthetists
RCoA have developed their own CPD E-Learning course specifically on how to minimise the environmental impact of anaesthesia
Discussion Ideas with Patients and Colleagues
Patients:
"Pre-habilitation will really help improve your outcome after the operation. Eating less meat and more Plant-based food could help improve your health before an operation and walking and cycling rather than driving will improve your fitness and speed up your recovery"
Colleagues
"How do you think we could reduce our nitrous oxide use in our department?"
"Could we run an educational session on the benefits of Total Intravenous Anaesthesia (TIVA) over gas anaesthesia?"
Highest impact actions for Anaesthetic Departments
Reduce the use of anaesthetic gases as much as possible.
Where it is not possible to reduce anaesthetic gases, use them as efficiently as possible, ideally with a capture system
Educating patients in pre-operative clinics on the health (and environmental) benefits of plant-based diets and active travel
Reduce the use of single-use plastics where possible and dispose of drugs in bins rather than down sinks.
Check out the impact of your anaesthetic below:
For More Information
The Royal College of Anaesthetists has lots of useful information on reducing the environmental impact of your anaesthetic
Greener Healthcare and Sustainability Project (GHASP) is a community of individuals founded initially as an anaesthetic specific group, but now has a broader multi-specialty scope. Click below for more information: