Dan Longrois, Chairperson of the NASC, on behalf of the NASC and the Board of Directors of the ESA; and Pierre Albaladjo, French Council representative and member of the Board of Directors of the SFAR
The ecological impact of all human activities cannot be denied. The consequences are such that many initiatives have been launched to decrease/control such impact. Providing anaesthesia care certainly has an ecological impact. From waste from single use material (plastic from the syringes and plastic bags of volume expanders, glass from the vials, metal needles, and many others) to anaesthetic gases and obsolete monitors and devices, many of the routinely used objects in anaesthetic practice must be dealt with in terms of ecological impact.
The estimated number of anaesthetic procedures worldwide is more than 250 million. A single patient undergoing complex surgery probably generates several kilograms of waste. At the level of the planet, that may be quite a large quantity. At least part of the ecological impact of anaesthesia practice can be avoided and programs to manage the ecological impact of anaesthetic practice are therefore a necessity.
As part of its policy to meet the representatives of large National Anaesthesiologist Societies (NAS) that are part of the NAS Committee (NASC) and ESA, several representatives of the ESA Board of Directors met the president and members of the Board of Directors of the French Society of Anaesthesia and Intensive Care (Société Française d’Anesthésie et de Réanimation, or SFAR) in September 2017. On this occasion we were informed that SFAR has an ongoing program of Sustainable Anaesthesia that covers several actions.
Following this encounter, the Board of Directors approved an initiative proposed by the NASC chairperson to inquire of all NAS on the existence of projects, ongoing programs, or interest in Sustainable Anaesthesia. All NAS replied and we found that with the exception of SFAR, no other NAS had an ongoing program of Sustainable Anaesthesia, a few had projects, and all were interested in such a program. Following this information, the NASC chairperson met with several members of the Board of Directors of SFAR and obtained approval for a collaboration, based on a Memorandum of Understanding that needs to be created, between the ESA and SFAR to build an ESA-wide program of Sustainable Anaesthesia. Its goals and its tools need to be defined and refined, together with the tools to follow implementation and measure the impact of such a program. The SFAR-created project on Sustainable Anaesthesia can be consulted on the SFAR website.
SFAR has created a Sustainable Anaesthesia Group whose president is Dr Jane Muret, who works in close collaboration with Prof Pierre Albaldejo, who is the French Council member in the ESA Council. The goals of the Sustainable Anaesthesia project as explicated by the SFAR and that could be shared by ESA and the NAS are to: (i) create a network of NAS and Departments of Anaesthesiology in all NAS that can be identified as such as contributing to the program; (ii) collect and value local initiatives on Sustainable Anaesthesia; this could be a model of network collaboration; (iii) create a culture of Sustainable Anaesthesia that could become routine practice for medical and non-medical anaesthesiology personnel; educational tools, conferences, and measurable actions need to be created so that they become an additional part of patient (and planet) safety; (iv) create a web platform so that all these tools conceived by one group can be rapidly shared by all other NAS, hospitals, Departments of Anaesthesia, and individual professionals.
What is next for this project? The first element will be the MoU between SFAR and ESA so that the program evolves from France through ESA/NASC to all interested participants. The second will be the creation of the Sustainable Anaesthesia ESA/NASC network whose implementation must be financed. Third, there will the opportunity of implementing ‘crowd knowledge’ to the development of the program by the implementation of the web platform to share initiatives.