Anaesthetic Gases & Metered Dose Inhalers

Entonox, anaesthetic gases and metered dose inhalers all have extremely high carbon equivalent factors. This means that a small amount of a medical gas (eg desflurane) has the same impact as a huge quantity of carbon dioxide.

In 2019/20, our use of Nitrous Oxide and Entonox alone emitted the equivalent of 2,868 tonnes of CO2. That's the same as driving 7.2 million miles in an average car!

It's therefore an important early priority to make sure our anaesthesia is as green as possible.

Changing which anaesthetic gas we use, adopting new low flow anaesthetic machines, and using total intravenous anaesthesia can all have an impact. We can also use gas scavenging systems to capture and break down these harmful gases.

Metered Dose Inhalers (MDIs) use a hydrofluorocarbon propellant, which is then released into the atmosphere as the medicine is delivered. Dry power inhalers have a lower carbon impact, but cannot be used in very young children.

These areas show the complex decisions and clinical innovation that is needed to make NHS care 'climate safe'.

An anaesthetic machine

What we've done

  • Begun investigated technologies to destroy Nitrous Oxide after patient use.
  • Collected inhaler data to begin establishing use patterns.
  • Created a dedicated group to look at medical gases and inhalers.

What we're doing

  • Quantifying our use of our medical gases.
  • Quantifying our use of MDIs and look at recycling options.
  • Reviewing our Medical Gas Policy to include best practice in gas management.
  • Investigating leaks and expired cylinders management.
  • Exploring how we make sure children are on the right inhalers

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