Background: Global warming presents major public health challenges, with healthcare transportation significantly contributing to carbon dioxide equivalent emissions (eCO). While the greenhouse effects of anaesthetic gases are well-documented, the eCO of pre-anaesthesia consultations remains underexplored. This study aims to evaluate and propose strategies to reduce the carbon impact of these consultations at a Tertiary University Hospital.
Methods: In a prospective, observational study over one month, data were collected from patients attending pre-anaesthesia consultations. ECO2 emissions from transportation and electricity were calculated. To reduce emissions, several modifications to the care pathway were investigated, including teleconsultation, remote consultation, grouping of consultations, carpooling, and the promotion of public transport. The effects of current and optimised care pathways were then compared.
Results: Data from 213 patients showed that 75% attended the hospital solely for pre-anaesthesia consultations, mostly by car (82%). The mean eCO per consultation was 22.4 kgCO2 (95% CI: 14.6-30.2). Implementing optimisation strategies in 65% of cases could reduce emissions to 5.6 kgCO2 (95% CI: 0.2-10.9) per consultation, leading to a 74% reduction and an annual saving of 274 tonnes of eCO.
Discussion: Our study highlights the potential for significant reductions in the eCO of pre-anaesthesia consultations. The adaptation of the care pathway would largely involve grouping consultations and developing teleconsultations. These potential savings in greenhouse gas emissions are in the same order of magnitude as not using desflurane in the operating theatre and could be the next step towards greener anaesthesia.
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http://dx.doi.org/10.1016/j.accpm.2024.101462 | DOI Listing |
Anaesth Crit Care Pain Med
December 2024
Department of Anaesthesia and Intensive Care, North Hospital, Marseille, France.
Background: Global warming presents major public health challenges, with healthcare transportation significantly contributing to carbon dioxide equivalent emissions (eCO). While the greenhouse effects of anaesthetic gases are well-documented, the eCO of pre-anaesthesia consultations remains underexplored. This study aims to evaluate and propose strategies to reduce the carbon impact of these consultations at a Tertiary University Hospital.
View Article and Find Full Text PDFRev Esp Anestesiol Reanim (Engl Ed)
December 2024
Hospital Universitario Infanta Leonor, Madrid, Spain.
The main objectives of the pre-anaesthesia consultation are to establish the patient's anaesthesia and surgical risk, evaluate and optimize their health status, provide the patient with information and preoperative recommendations, and fulfil the legally established bureaucratic obligations. The incorporation of information technologies - e-Health - has maximised the efficiency of pre-anaesthesia assessments and provided patients with an added benefit. The SEDAR Task Force has developed a digital framework as an alternative to the conventional pre-anaesthesia assessment process, and has put forward a series of policies and technical recommendations for the incorporation of different types of pre-anaesthesia teleconsultation services in hospital anaesthesiology departments.
View Article and Find Full Text PDFPerioper Med (Lond)
June 2024
Department of Anaesthesiology and Intensive Care Medicine, School of Medicine, University of Ulm, Albert-Einstein-Allee 23, Ulm, 89081, Germany.
Background: Surveys suggest a low level of implementation of clinical guidelines, although they are intended to improve the quality of treatment and patient safety. Which guideline recommendations are not followed and why has yet to be analysed. In this study, we investigate the proportion of European and national guidelines followed in the area of pre-operative anaesthetic evaluation prior to non-cardiac surgery.
View Article and Find Full Text PDFCureus
January 2024
Epidemiology and Public Health, Laboratory of Community Health, Preventive Medicine and Hygiene, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR.
Introduction: Patient safety in anaesthesia has significantly improved over the past decades, largely due to pharmacological and technological advancements, as well as the widespread adoption of guidelines and standards recommended by international organisations. This study aimed to evaluate the practice of anaesthesia and its compliance with the international standards for safe anaesthesia practice recommended by the World Federation of Societies of Anaesthesiologists (WFSA) and the World Health Organization (WHO). This study also describes the operating room within Ibn Sina University Hospital Centre (CHUIS) of Rabat, Morocco, the referral centre, with the aim of identifying its potential and shortcomings.
View Article and Find Full Text PDFJ Telemed Telecare
January 2024
Department of Anaesthesia and Intensive Care, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.
Background: Although telemedicine with video support for preoperative evaluation has been found effective, there is limited research on anaesthesia consultation by phone without video support, particularly among high-risk patients. To evaluate the effectiveness, safety and potential benefits of performing pre-anaesthesia evaluation by phone before eye surgery in patients having non-invasive surgery, we performed an observational study in a French teaching hospital.
Method: All elective patients having elective ophthalmic surgery were included to have a consultation by phone instead of an in-person consultation, regardless of the type of anaesthesia or ASA score.
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