Penn Medicine anesthesia, waste initiatives boost OR sustainability

Editor's Note

Penn Medicine has made significant strides in reducing the environmental footprint of the OR through department- and team-level initiatives, according to a March 29 report in Penn Medicine news.

Driven by CIRCE: Medicine, a faculty group consisting of providers from Penn Medicine and Children’s Hospital of Philadelphia, examples of these initiatives include reducing anesthesia “flow rates,” phasing out the use of certain gases, streamlining instrument sets, and reducing waste.

The flow reduction initiative reportedly dropped greenhouse gas emissions at the Hospital of the University of Pennsylvania by the equivalent of 30 metric tons of carbon dioxide between April and June 2023. This was achieved by affixing magnets to anesthesia machines encouraging the use of lower flows. This contrasts with the traditional approach of using higher flow rates to ensure sufficient medication, a consideration made obsolete by technology, the report notes. The OR also phased out the use of desflurane, an anesthetic gas that is particularly damaging to the environment.

Meanwhile, removing unused surgical instruments from the standard set prepared for each procedure has reduced the use of chemical solvents during cleaning. Another initiative focused on Penn’s practices surrounding “red bag” waste—trash that has been soiled with blood and must be deposited in red cans. Simply swapping standard-size red bag bins for smaller ones was a “game changer” for Perelman Center’s outpatient Surgicentre, says Julia Tchou, MD, PhD, the center’s environmental supervisor.