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Implementing nitrous oxide cracking technology in the labour ward to reduce occupational exposure and environmental emissions: a quality improvement study.
Pinder, A; Fang, L; Fieldhouse, A; Goddard, A; Lovett, R; Khan-Perez, J; Maclennan, K; Mason, E; MacCarrick, T; Shelton, C.
Afiliación
  • Pinder A; North West School of Anaesthesia, Health Education England North West, Manchester, UK.
  • Fang L; North West School of Anaesthesia, Health Education England North West, Manchester, UK.
  • Fieldhouse A; North West School of Anaesthesia, Health Education England North West, Manchester, UK.
  • Goddard A; North West School of Anaesthesia, Health Education England North West, Manchester, UK.
  • Lovett R; Manchester Birth Centre, St Mary's at Wythenshawe Hospital, Manchester, UK.
  • Khan-Perez J; Department of Anaesthesia, St John's Hospital, Livingston, UK.
  • Maclennan K; Department of Anaesthesia, St John's Hospital, Livingston, UK.
  • Mason E; North West School of Anaesthesia, Health Education England North West, Manchester, UK.
  • MacCarrick T; Department of Anaesthesia, Manchester Royal Infirmary, Manchester, UK.
  • Shelton C; Manchester Birth Centre, St Mary's at Wythenshawe Hospital, Manchester, UK.
Anaesthesia ; 77(11): 1228-1236, 2022 11.
Article en En | MEDLINE | ID: mdl-36108342
Nitrous oxide, a potent greenhouse gas, is a common labour analgesic. One method which may reduce its carbon footprint is to 'crack' the exhaled gas into nitrogen and oxygen using catalytic destruction. In this quality improvement project, based on environmental monitoring and staff feedback, we assessed the impact of nitrous oxide cracking technology in the maternity setting. Mean ambient nitrous oxide levels were recorded during the final 30 minutes of uncomplicated labour in 36 cases and plotted on a run chart. Interventions were implemented in four stages, comprising: stage 1, baseline (12 cases); stage 2, cracking with nitrous oxide delivered and scavenged via a mouthpiece (eight cases); stage 3, cracking with nitrous oxide via a facemask with an air-filled cushion (eight cases); stage 4, cracking with nitrous oxide via a low-profile facemask, and enhanced coaching on the use of the technology (eight cases). The median ambient nitrous oxide levels were 71% lower than baseline in stage 2 and 81% lower in stage 4. Staff feedback was generally positive, though some found the technology to be cumbersome; successful implementation relies on effective staff engagement. Our results indicate that cracking technology can reduce ambient nitrous oxide levels in the obstetric setting, with potential for reductions in environmental impacts and occupational exposure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Exposición Profesional / Gases de Efecto Invernadero Límite: Female / Humans / Pregnancy Idioma: En Revista: Anaesthesia Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Exposición Profesional / Gases de Efecto Invernadero Límite: Female / Humans / Pregnancy Idioma: En Revista: Anaesthesia Año: 2022 Tipo del documento: Article Pais de publicación: Reino Unido