PHEPB - Sustainable Practice in Medicine

Question 1

Define climate crisis

Answer 1

A situation characterised by the threat of highly dangerous, irreversible changes to the global climate

Question 2

Explain how the climate crisis is a health crisis

Answer 2

• Flash floods, wildfires, air pollution, drought, rising sea lvls
• Burden on basic living and access to healthcare, say for example drought, which will have an impact of food security
• Healthcare burden via increasing climate related disease
  
  • Air pollution can have direct impact on patient health
• Many changes that are good for health are also great for environment

Question 3

What are the 2 targets NHS England has to address the climate crisis?

Answer 3

• For the emissions NHS controls directly (NHS carbon footprint), NHS England will reach net zero by 2040, with an ambition to reach an 80% reduction by 2028 to 2032
• For the emissions NHS England can influence (NHS Carbon Footprint Plus), will reach net zero by 2045, with an ambition to reach an 80% reduction by 2036 to 2039

Question 4

Why is sustainable healthcare important?

Answer 4

Supporting sustainable healthcare can benefit both patients and the wider system. Benefits include reduced environmental health risks, reduced costs and increased resilience of health systems and workforce (NICE)

Question 5

What are sources of high carbon in surgery?

Answer 5

• Anaesthetic gases are often more potent greenhouse gases than carbon
• Lots of electricity used
• Pumps - to control temp, blow away infectious agents from patients

Question 6

How can anaesthetic gas be changed to be more climate friendly?

Answer 6

Anaesthetics has switched from nitrous oxide to sevoflurane, which emits far less it’s equivalent CO2 emissions than NO.

It’s also switched to intravenous drugs instead of gas

Question 7

How is surgical equipment being changed to be more sustainable?

Answer 7

• Surgeons are only using the equipment they actually need to use, this is helping to avoid throwing away equipment unneccesarily (as each instrument must be discarded after a surgery, instruments are single use)
• Some equipment is now reusable, and can be sterilised, e.g. ports used during keyhole surgery

Question 8

How are inhalers being changed to be more sustainable?

Answer 8

• Salbutamol inhalers need fluorocarbon to reach airways/lungs, equivalent CO2 output of a car driving 175 miles
• Dry powder inhalers - Single use capsules that you drop into the chamber, don’t use as much, equivalent CO2 output of a car driving 4 miles

Question 9

What non-medical ways are hospitals ensuring sustainability?

Answer 9

• Not wearing gloves when you don’t need to
• Putting only stuff that’s been in contact with patient in orange bin, which will then be incinerated at high temp, releasing lots of CO2