Metamorphosis or bust!

nesting curlew

Images curtesy of Birdwatch Ireland. Nesting curlew - Derek Belsey and Cliff Reddick

The Irish healthcare industry is slowly waking up. There is an increasing realisation that no sector of society – including healthcare – can have a free pass from the re-design that is required to make them more sustainable. Teams of engineers are re-designing physical structures and modifying processes to reduce energy utilisation by the national public health service. Direct action is also beginning at the clinical coal face, and anaesthesiology is at the forefront of this transformational process.

In early 2020 the CAI became the first of the Irish medical specialty colleges to set up a sustainability committee. This committee, comprising anaesthesiologists and college officials, has engaged dynamically in order to reduce the environmental footprint of our specialty rapidly. The main focus initially was to reduce anaesthetic greenhouse gas emissions. This project has three components. Firstly, we audited the quantities of anaesthetic and analgesic gases used in almost 60 public and private hospitals during the calendar year 2019. These data have been analysed, converted into clear diagrammatic form, and integrated into a 2-page summary that has been given to each anaesthetic department. It is hoped that, now anaesthesiologists in every institution in the country understand the magnitude of their greenhouse gas footprint along with the relative contributions of various agents, they will take effective actions to reduce their emissions. We plan to repeat the audit when the pandemic pressures on the system ease, and develop further action as appropriate.

The Arctic nations have the polar bear, the Indians the Bengal tiger, and the Chinese the giant panda. In Ireland the species that is becoming a particular focal point of conservation efforts is the curlew.

The second step that we have taken to reduce our anaesthetic emissions was inspired by the wonderful work of Alifia Chakera and others. The CAI is collaborating with the national public health service in Ireland to reduce nitrous oxide venting to the atmosphere through leaks or sub-optimal stock management. We have also begun communicating with individuals in Brussels with the goal of trying to make the venting of nitrous oxide to the atmosphere by medical gas manufacturers illegal across the EU.

The third component of our drive to reduce greenhouse gas emissions is a specialty-wide information campaign to raise awareness of the global climate implications of the seemingly innocuous choices we make every day. A sustainability-themed webinar, newsletter, and annual scientific meeting session are among the initiatives that we have used to promote alternatives to the more damaging modes of anaesthesia and analgesia lurking in our armoury. We will run a TIVA workshop at the CAI’s 2022 Annual Scientific Meeting to facilitate its wider adoption, as it is the greenest way to deliver general anaesthesia.

The Arctic nations have the polar bear, the Indians the Bengal tiger, and the Chinese the giant panda. In Ireland the species that is becoming a particular focal point of conservation efforts is the curlew. Irish curlew numbers have declined by a catastrophic 96% since the 1980s. This decline is mainly due to habitat destruction by humans, but climate change is a headwind for almost every species. We are excited that a new prize to encourage research in sustainability will be awarded at the Annual Scientific Meeting from May 2022 onwards. This prize will be known as ‘The curlew prize’. It will be awarded for the best abstract relating to sustainability in anaesthesiology; B.Braun Ireland have graciously agreed to sponsor this award.

There’s an old Irish saying: ‘tús maith, leath na h-oibre’, which translates as ‘a good start means half the work is done’. We wish to thank most sincerely our colleagues in England, Scotland and Wales for their encouragement and support in helping us get a good start on our metamorphosis to a beautiful green butterfly. Please tweet us @COAIrlsustain.

Ola Løkken Nordrum
Anaesthesia Communications Lead, National Anaesthetic Gas Mitigation Project
SAT 1 Trainee, Galway University Hospital, Galway

Vincent Wall
Public Relations Officer, CAI Sustainability Committee
Cardiothoracic Anaesthesiology Fellow, Mater Misericordiae Hospital, Dublin

Dónall Ó’Cróinín
Chair, CAI Sustainability Committee
Consultant Anaesthesiologist, Mercy University Hospital, Cork

Twitter: @OlaLN; @vinniewall2; @docroinin

Log in to read more articles from this issue of Anaesthesia News:

Juggling anaesthesia training with a long-term illness - a personal perspective

I was diagnosed with a long-term illness (LTI) after completing my first year of training in anaesthesiology. Initially I was unable to walk or hold my six-month old son with confidence.

Teamwork

I’m currently a final year anaesthesiology trainee with the CAI. I have combined my 14 years of medical training with the life of an elite athlete playing with my home county Dublin.

Poetic fumes and anaesthesia

There is poetry in all of us. There is music in every soul. But only a few pick up the pen to let it flow out. I am one such person. Poetry was my first love, and anaesthesia was a later choice in life.

Elections to Association of Anaesthetists Board and Council

There are three vacancies for election to the Association’s Board and we would like to encourage all members to consider standing for election this year. The only requirements are to be a Full Member of the Association in good standing, and to be legally eligible to serve as a company director and a charity trustee.

Metamorphosis or bust!