Oral, in place of intravenous, paracetamol as the new normal for elective cases

Myo, J.; Pooley, Sunshine; Brennan, Fiona

doi:10.1111/anae.15482

Cited by 13 publications

(5 citation statements)

References 3 publications

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“…We can estimate a carbon footprint for aspects of antimicrobial use such as the ancillary plastic products used for different routes of administration. A study by Myo et al [ 59 ] has shown that oral (PO) paracetamol therapy can be provided at an approximately 68-fold lower carbon footprint compared to intravenous (IV) paracetamol in glass packaging and 45-fold lower in plastic packaging. We anticipate that the relative carbon footprints of PO and IV antimicrobials would be similar.…”

Section: Four Key Principles Of Sustainable Healthcarementioning

confidence: 99%

Improving Antimicrobial Use to Protect the Environment: What Is the Role of Infection Specialists?

Walpole

Eii

Lyons³

et al. 2023

Antibiotics

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Anthropogenic environmental changes are causing severe damage to the natural and social systems on which human health depends. The environmental impacts of the manufacture, use, and disposal of antimicrobials cannot be underestimated. This article explores the meaning of environmental sustainability and four sustainability principles (prevention, patient engagement, lean service delivery, and low carbon alternatives) that infection specialists can apply to support environmental sustainability in health systems. To prevent inappropriate use of antimicrobials and consequent antimicrobial resistance (AMR) requires international, national, and local surveillance plans and action supporting antimicrobial stewardship (AMS). Engaging patients in addressing environmental sustainability, for example through public awareness campaigns about the appropriate disposal of unused and expired antimicrobials, could drive environmentally sustainable changes. Streamlining service delivery may include using innovative methods such as C-reactive protein (CRP), procalcitonin (PCT), or genotype-guided point of care testing (POCT) to reduce unnecessary antimicrobial prescribing and risk of adverse effects. Infection specialists can assess and advise on lower carbon alternatives such as choosing oral (PO) over intravenous (IV) antimicrobials where clinically appropriate. By applying sustainability principles, infection specialists can promote the effective use of healthcare resources, improve care quality, protect the environment, and prevent harm to current and future generations.

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Section: Four Key Principles Of Sustainable Healthcarementioning

confidence: 99%

Improving Antimicrobial Use to Protect the Environment: What Is the Role of Infection Specialists?

Walpole

Eii

Lyons³

et al. 2023

Antibiotics

View full text Add to dashboard Cite

show abstract

“…By accessing the trusts contracts and using the appropriate GHG conversion factors, we were able to calculate scope 1 and 2 emissions. All additional sources of inventory reconciliation including scope 1 and 2 data can be visualised in Figure 4 [20][21][22][23].…”

Section: Additional Data Sourcesmentioning

confidence: 99%

“…Parvatker et al 2019 20 3 Secondary Carbon impact of the pharmaceuticals (except paracetamol) [20] Myo et al 2021 21 3 Secondary Carbon impact of paracetamol [21] Burguburu et al 2022 22 3 Secondary Lifecycle Carbon impact of Scrubs [22] Rizan & Lillywhite 2022 23 3 Secondary Carbon impact of sterilisation [23] Greenhouse The site has a mix of energy sources, using grid electricity, gas, and a large onsite CHP plant N/A…”

Section: Data Source Scope Type Operative Data Used Referencementioning

confidence: 99%

The Carbon Footprint of Spinal Surgery: Experiences of a Tertiary Centre

Shah,

George,

Barnard

2023

Preprint

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The operating theatre represents a key contributor to healthcare-derived emissions. Here, we outline the carbon footprint of a lumbar microdiscectomy at our regional unit in Greater Manchester, with the use of AI technology. In doing so, we aim to define the extent of the environmental impact and identify carbon hotspots for sustainable change. Our unit of analysis covered the start of the patient journey into hospital through to the final outpatient appointment. Publicly available and locally sourced data was used. An inventory analysis of two lumbar microdiscectomies was conducted. Each item was categorised reconciled against our AI-powered ‘CO2 analysis’ database. Kilograms of carbon dioxide equivalent (kg CO2e) was chosen as the primary measure of impact. An average lumbar microdiscectomy at our trust generates 477.73kg CO2e. The operation (173.89kg CO2e, 36.40%) and the inpatient stay (144.67kg CO2e, 30.28%) constituted the biggest contributors. Single-use intraoperative equipment contributed to over three-quarters of the total emissions from the operation. By defining the environmental burden of elective spinal surgery, we have identified carbon hotspots to target for sustainable change. Substituting polluting elements for carbon-friendly alternatives and challenging the single-use culture, modern healthcare systems can help pave the way to a ‘net zero’ healthcare system.

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“…Studies have shown that there is no significant difference between intravenous (IV) and oral preparations in postoperative pain outcomes. [1,2] We proposed moving towards routine administration of oral paracetamol before surgery to reduce the use of IV preparations, with benefits of carbon and cost reduction.…”

mentioning

confidence: 99%

“…If we achieve 100% adherence, this will increase to 3,741 kg of carbon dioxide and £28,037 per year respectively. [2,3] Discussion: Routine use of preoperative oral paracetamol has resulted in a significant reduction in the use of intravenous preparations. Extrapolated across the whole hospital, there are large carbon and cost savings to be made.…”

mentioning

confidence: 99%