Change in laughing gas supply is no joke as health board makes significant sustainable change

PICTURED: Paul Lee, Head of Medical Equipment Management Services, and Duncan Davies, Acute Site Pharmacy Manager in Morriston Hospital, with a cylinder which is now being used for supplying patients with nitrous oxide.  

A Swansea Bay project has proved it’s not a pipe dream as it remains on course to significantly reduce the health board’s carbon footprint.

A review of the health board’s usage of nitrous oxide – commonly known as laughing gas – has identified a change in its supply which would have far less of an impact on the environment without affecting patient care.

Nitrous oxide is a medical gas that is used across the health board’s hospitals by services such as theatres, labour ward and the Emergency Department.

It is, however, a potent greenhouse gas – 300 times more so than carbon dioxide.

A project led by Dr Elana Owen, Consultant Anaesthetist and Clinical Lead for Sustainability, has looked into the benefits of switching the health board’s supply of nitrous oxide from its manifold system and pipework to cylinders at the point of use.

Early investigations have shown changing to a cylinder supply is more efficient and less wasteful, where supply is more likely to match demand.

Analysis indicates that as well as being better for the environment, this could lead to a financial saving too.

PICTURED: Operating Department Practitioner Gemma Hale and Dr Elana Owen, Consultant Anaesthetist, have championed the change in nitrous oxide supply.

Dr Owen said: “Anaesthetic gases contribute to around five per cent of the total NHS carbon footprint, with nitrous oxide still occasionally used in anaesthetic practice - most frequently in paediatrics and obstetrics.

“Nitrous oxide has the largest carbon footprint of the anaesthetic gases within the acute sector, accounting for at least 80 per cent of the total anaesthetic gas footprint in 2019/20. The global warming potential of nitrous oxide is 300 times that of carbon dioxide, and it remains in the atmosphere for more than a century.

“We surveyed all anaesthetists in Swansea Bay UHB, and 94 per cent were happy for the piped supply to be removed and replaced with the cylinder supply.

“We initially held a trial in certain theatres, which proved so successful that we have since expanded the trial, and all our theatres in Morriston and Neath are now disconnected from the nitrous oxide manifolds, and rely solely on the cylinders.”

Dr Owen is one of three Sustainable Clinical Leads within the health board, with the role running alongside her day-to-day clinical responsibilities.

The role’s primary function is to embed sustainability across the health board to meet climate change objectives and work closely with colleagues and staff groups.

The nitrous oxide project is among her main projects, which has benefited from a multi-department approach.

Dr Owen added: “This project has received excellent and essential support from a range of our departments including estates, Medical Equipment Management Services, theatres, anaesthetic assistants and pharmacy.

“Representatives from these departments have been involved from the very beginning, and their continued input is integral to the success of the project.

“We made good progress across our main hospitals, but there’s still plenty to achieve as the project is very much ongoing.”