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Successful trial for sustainable gas and air healthcare technology

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Cardiff and Vale University Health Board (UHB) has utilised new green technology for childbirth, marking a significant milestone in reducing nitrous oxide emissions.

Nitrous oxide has been a critical aspect of healthcare delivery, and is commonly used in anaesthetics. However, studies have shown nitrous oxide has more than 265 times the global warming potential than carbon dioxide (CO2).

Entonox, commonly known as gas and air, is a combination of nitrous oxide and oxygen. In Cardiff and the Vale of Glamorgan, the use of Entonox is equivalent to emitting 4495 tonnes of CO2 every year.

Entonox Carbon Reduction Units have been developed in Sweden and are able to collect exhaled nitrous oxide and ‘crack’ it into nitrogen and oxygen – which are deemed harmless.

Cardiff and Vale UHB has worked closely with patients and staff on the implementation of the Entonox Carbon Reduction Units. The Entonox project forms part of wider activity to reduce the use of nitrous oxide across Health Board sites.

There are currently four nitrous oxide manifolds across the Health Board’s sites which are the typical method of storage.

Findings by a Cardiff and Vale UHB multi-disciplinary project team have found that wastage from this type of system can be high due to leaks and loss of gas from the supply.

The Health Board has trialled portable nitrous oxide cylinders at the Children’s Hospital for Wales as part of an individual pilot which has increased efficiency considerably, from 2.5% to 74%.

Following the successful pilot, the team scaled the pilot study across the organisation through The Spread and Scale Academy, with ambitions to share insights and encourage change across Wales.

To date, the Health Board’s University Hospital Llandough site has fully decommissioned its nitrous oxide manifold and plans are underway to decommission the main manifold at University Hospital of Wales.

The Healthcare Without Harm Report says 5.6% of UK emissions are from healthcare settings and the NHS Wales Decarbonisation plan highlights anaesthetic gases reduction.

The Health Board has projected savings of 1.15 million litres of nitrous oxide or 679 tonnes of CO2 each year.

Charlotte Oliver, Consultant Anaesthetist and one of the Clinical Leads for the project at Cardiff and Vale University Health Board, said: “I’m really proud of the hard work the team has put in to get us to this point, challenging norms of care that have been around for decades and allowing us to bolster our commitment to reducing our environmental impact.”