Patient warming
Ensuring sustainable patient warming
Sustainability in healthcare is not just about plastic packaging and recycling, says Kevin Robinson. When maintaining normothermia in surgical patients, it is important to find the right balance of different modalities across the patient warming workflow to improve patient outcomes and achieve sustainability goals for the healthcare provider.
In 2010, Sir Dave Brailsford was appointed as General Manager and Performance Director of Great Britain’s professional cycling team, Team Sky. He was an advocate of the concept referred to as the “aggregation of marginal gains”, a theory that the amalgamation of refining everything by just 1% would amount to a much greater affect in improvement. That strategy proved to be successful, as Team Sky went on to win the Tour de France four times, and the British cycling team won 70% of the gold medals at the 2012 Olympic Games. In recent years, most of us have become very
aware of climate change. In the UK alone we have experienced +40˚C temperatures, severe flooding, destructive storms, droughts, forest fires and coastal erosion. The last four decades have all been warmer than any previous decade since 1850, with the last being the warmest on record.1 The primary cause is greenhouse gas emissions trapping the sun’s heat and causing the earth’s surface temperature to increase. Since the start of the industrial revolution in the 1800s, it has risen by approximately 1.2˚C, with human behaviour being the main driver for this.
Most recognise the main cause of
greenhouse gases is through the burning of fossil fuels and the main contributors being energy, industry, transport, buildings, and agriculture. However, many may be surprised to realise the contribution the healthcare sector has on greenhouse gas emissions. Approximately 5% of global greenhouse gas emissions are generated by healthcare,2 compared to 2.5% from aviation,3
intensive areas of a hospital using 3-6 times more energy than clinical wards, and accounting for 10% of the NHS carbon footprint.3 While most energy consumption is due
to heating, ventilation, and air-conditioning, 1.5-8.4% results from plug-loads and lighting.3 In a case study from Swansea Bay hospital, it was estimated they would reduce CO2
e by with one of the
carbon hotspots being the perioperative and intensive care areas. The main components that contribute to the carbon footprint are:3 l Anaesthetic agents and gases l Energy consumption used for OR maintenance (HVAC, lighting)
l Water l Pharmaceuticals l Complex supply chains l Waste management
The biggest contributors are anaesthetic gases, energy usage and products used in surgery.3 Operating departments are the most energy
144.8 tonnes and save around £26,000 a year by simply switching off non-essential equipment during non-planned surgery hours.3 Operating departments have high product use and consumption and produce about 20% of total hospital waste.4
In England single-
use products account for 68% of the carbon footprint of products used in the five most common operations.3
a typical operation in the US, Canada and UK produced between 146-232kg of CO2
equal to driving 400-650 miles in an average petrol car.3
One study estimated that e, which is The same study estimated that a
large UK hospital generates over 5,000 tonnes of CO2
e per year, which is equal to driving round the globe 580 times.3 Over the last 30 years, to reduce the risk of infection, there has been an increase in single- use devices, which was exacerbated during the COVID-19 pandemic. Blood pressure cuffs, pulse oximetry probes, laryngoscopes, some complex instruments, and surgical drapes are now single use, despite WHO finding no evidence of different infection rates for single use versus reusable drapes.3
They also say that approximately 85% of
hospital waste is non-hazardous.5 While reuse is not appropriate for all devices,
switching where appropriate will reduce carbon footprint by 38-56%, as the energy burden associated with waste processing and transport is greater than laundering and sterilisation.3,5 The Glasgow Declaration for Sustainability within Anaesthesiology and Intensive Care is the road map to environmental sustainability within the fields of anaesthesiology, and is based on the European Green Deal, which
56
www.clinicalservicesjournal.com I July 2024
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
