1. Reduce
- Reduce energy use by turning off lights and equipment at the end of the day, using HVAC setback systems and/or occupancy sensors
- Reduce unnecessary waste by ensuring appropriate waste segregation
- Reduce pharmaceutical drug waste (e.g. use prefilled syringes, refrigerate unused drugs, use drugs that are close to expiry first)
- Reduce redundant items on surgical trays
- Reduce redundant items in custom packs
- Reduce the use of blue wrap
- Reduce greenhouse gas emissions from inhalational anesthesia
- Do not use desflurane
- Avoid the use of nitrous oxide if possible
- Decommission the use of nitrous oxide through central piping systems and use portable canisters instead
- Minimize fresh gas flows (≤ 1L/min)
2. Reuse
- Use reusable medical devices
- Use reusable textiles (e.g. surgical gowns)
- Use reusable sharps containers
- Collect single-use medical devices for remanufacturing and reuse whenever possible
3. Recycle
- Develop and implement an effective recycling program in the OR. To ensure effectiveness, assess recycling procedures at your hospital (e.g. downstream processes and recycling hauler regulations) prior to implementation.
- Develop and implement specialized recycling programs if feasible (i.e. PVC, blue wrap, batteries, copper)
4. Rethink
- Rethink disposal of unused supplies, older machines and devices and consider donation where appropriate
- Rethink all procurement decisions by implementing an Environmentally Preferrable Purchasing policy
- Rethink traditional hand scrub and consider the use of alcohol hand rub
- Rethink anaesthetic techniques other than inhalational anaesthesia