Critical care: from ‘carbon hotspot’ to net zero

A new framework shows that by re-thinking resource use within critical care settings in hospitals, it’s possible to reduce their carbon and environmental footprint.

A critical care clinician in the critical care unit wearing a reusable gown. Around him are various pieces of medical equipment. The framework is in the early stages of being rolled out at Western Health.

The healthcare sector is responsible for 4-5 per cent of global greenhouse gas emissions and if it were a country, it would be the fifth highest emitter on the planet.

Dr Forbes McGain OAM, Associate Dean Sustainability, at the University of Melbourne, together with colleagues from with University of Brighton and Shrewsbury and Telford Hospital, United Kingdom, and Hawke’s Bay Hospital, New Zealand, present a way to view environmental sustainability in critical care via the framework: avoid, reduce, reuse, recycle, rethink, which has been published recently in the British Journal of Medicine.

Dr McGain, a co-author on the report, said intensive care units (ICUs) are a considerable contributor to the carbon footprint of hospitals.

“The ICU is a ‘carbon hotspot’ within the hospital because it is always active, often has higher rates of room airflow (and thus heating, ventilation and air conditioning (HVAC)), and greater consumable use compared with general hospital wards,” he said.

“The key to environmental footprint improvement involves avoiding, reducing, reusing, and recycling without compromising safe, quality care, with simultaneous research into best practices and rethinking how ICUs can be more sustainable.

“By preventing unnecessary patient admissions and readmissions; avoiding and reducing ineffective tests and therapies such as daily chest x-rays or blood tests and shifting from single use to reusable items, for blood pressure cuffs, pulse oximeters, and laryngoscopes, it can lead to wider economic, and environmental gains.”

Dr McGain said clinicians can lower the ICU’s environmental burden through awareness of these carbon hotspots and by integrating carbon reduction in decision making and activities in clinical practice, while continuing to provide high quality care.

“Reducing the carbon footprint and resource use of critical care will require a committed effort across all healthcare professions, engineering, waste management and procurement services, along with hospital, industry, and government leadership,” he said.