coffee cups from
home to reduce the
use of throwaway
cups," adds Kim
Loew, RN, CASC,
director of nursing at
the Laser Spine
Institute in Oklahoma
City, Okla.
"All of my binders
(for example, risk
management and
infection control) are
now digital," says
Stacy Daugherty, RN,
endoscopy nurse
manager for Gastro-
enterology Associates
in Canton, Ohio.
"Everything is elec-
tronic with a backup
in a fireproof safe. No
more paper!"
Overall, the best
replacements are
those that deliver ben-
efits on multiple levels.
"Look for environmen-
tally friendly cleaning
options. They are out
8 4
O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | January 2015
I
nhalational anesthetics play a significant
role in the U.S. healthcare industry's carbon
footprint, but one hospital saw an 11-fold
reduction in greenhouse gas emissions simply
by avoiding the use of desflurane and nitrous
oxide.
According to research presented at the
American Society of Anesthesiologists' annual
meeting in October (tinyurl.com/qakspwp),
the 2 gases have the highest amount of associat-
ed carbon dioxide emissions among inhalational
agents. In contrast, sevoflurane and isoflurane are
20 times less polluting, and propofol 4 times less
so.
"Inhaled anesthetics are a really low-hanging
fruit to target for significant reduction in green-
house gas pollution," says Jodi Sherman, MD, an
assistant professor of anesthesiology and the
environmental compliance officer at Yale
University's School of Medicine, who led the
study at Yale-New Haven Hospital. In addition to
switching agents, Dr. Sherman recommends
adopting low-flow techniques, recapturing waste
gases and using regional anesthesia when practi-
cal.
— David Bernard
BrEaTHInG EaSIEr
Anesthetic Choice Has
Environmental Impact
