Intensive Care Units (ICU)
How Is Climate Change Affecting The Delivery of Intensive Care?
Climate change and the rise in extreme weather events are driving the demand for intensive care. Wildfires, heatwaves, floods and rising sea levels are contributing to heat-related illness, worsening or inducing respiratory conditions and altering the pattern of infectious diseases.
Warming climates and population displacement are contributing to antimicrobial resistance, bringing us closer to prescribing antibiotics of last resort. This has the potential to result in significant harm within intensive care, where previously treatable infections are no longer susceptible to our available antibiotics.
The increasing demand and health implications of the workforce also place significant demands on the mental health of intensive care staff. Resource allocation is a fundamental aspect of intensive care due to the limited resources, and increasing demand forces clinicians to make difficult decisions.
How is Intensive Care Affecting Climate Change?
Intensive care is incredibly resource and staff-intensive, providing life-saving intervention at the edge of life. Much of the equipment used is single-use and disposed of by incineration. One particular item is disposable gloves, with more than 100 used per patient per day in intensive care. The Intensive Care Society promotes the ‘gloves off in critical care’ campaign to reduce unnecessary use.
The electricity demand within intensive care is high, supplying monitors, ventilators, heating, infusion devices, ventilation, lighting, and so on. This increasing demand may be fulfilled by fossil fuel power stations, polluting the environment.
Medications, including propofol (a common sedation medication), are sometimes disposed of in sinks, where they enter the water systems. Propofol does not degrade and is toxic to aquatic life.
A Beginners Guide to: Green Teams in the ICU
The Intensive Care Society (ICS), in collaboration with the Australian and New Zealand Intensive Care Society (ANZICS) have published a comprehensive beginner’s guide to sustainability in the intensive care unit.
Discussion Ideas with Patients and Colleagues
Patients:
"Rehabilitation is important after admission to intensive care. Sustainable ways of enhancing your recovery include walking and cycling rather than driving."
"On hot days or during periods of poor air quality, stay indoors and hydrated to reduce your risk of becoming unwell."
Colleagues
"How can we reduce the amount of disposable equipment within the department?"
"Can we introduce reusable equipment instead of single-use items?"
"What steps can we take to ensure we’re recycling all recyclable items and packaging?"
"How can we work together to support each other during the increasing demand?"
Highest Impact Actions for Intensive Care Units
Embed climate change and sustainable healthcare into educational and governance sessions
Making recycling bins commonplace to avoid unnecessary incineration and landfill disposal of non-clinical waste.
Disposing of medications correctly to ensure they do not enter the aquatic environment.
Avoiding disposable gloves for routine examinations and preparing non-hazardous medications.
Introducing reusable equipment for new or replacement items, with procedures for safe decontamination.
Avoiding unnecessarily wasting or changing equipment, including medications, intravenous lines and blood bottles.