Topic

Ntirous Oxide in the ED

Sandy  Robertson
Sandy Robertson • 17 April 2022

Hello All,

We know that nitrous oxide is one of the largest carbon hotspots in our work in the emergency departments and it is good to see that there are a few alternatives available. 

We have been doing some work on this at RCEM primarily by raising awareness of the problem and looking at ways that we could create a life cycle analysis for methoxyflurane and nitrous oxide. 

It would be great to hear from anyone else who has been looking into this.

 

 

 

Comments (4)

Kate Townsend
Kate Townsend

Hi Sandy,

I work for the Greener NHS team in the South East and am working with Frimley and HIOW ICS on a Nitrous Oxide project. A company called MedClair have provided a portable machine that helps to capture and safely breakdown Nitrous Oxide - although they have based these in their maternity wards, rather than for ED.

Happy to have a chat with you if helpful. And/or can link you to the national medicines team within the Greener NHS as well. (kate.townsend5@nhs.net)

Bw

Kate

Tim Spruell
Tim Spruell

Quite a few EDs seem to have piped Entonox to resus. As EDs we could look at switching to portable cylinder only Entonox (when it is needed) as the piped systems are often associated with leaks, poor stock management at the manifold and expiry of cylinders. This leads to high levels of wastage from these kinds of piped systems. 

Emma Evans
Emma Evans

Hi we've switched to Penthrox for adukt procedural sedation and I'm currently trying to get an SOP to support others wanting to consider the same. Agree with Kate remove Entonox pipe work to ED as if you audit you'll likely not use that much. As a final part of the nitrous waste piece a destruction unit could be helpful but I'd work out what other options will allow you to reduce supply/use first

let us know where you are with it now!

 

Rachael Harding
Rachael Harding

Hi,

We're undertaking similar process in Cardiff currently - 1st aim is to switch from piped to cannisters. There is resistance to switching to penthrox due to cost. Before I reinvent the wheel, does anyone have (impartial) evidence demonstrating cost saving in the long term and/or the environmental impact (manufacture/disposal etc. as well as just the gas) vs. entonox.

Thank you!


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