Debois William, Prata Jessica, Elmer Barbara, Liu Junli, Fominyam Edward, Salemi Arash
New York Presbyterian Hospital-Weill Cornell Medical Center, New York, New York 10021, USA.
J Extra Corpor Technol. 2013 Jun;45(2):143-5.
The project goal was to reduce waste disposal volume, costs and minimize the negative impact that regulated waste treatment and disposal has on the environment. This was accomplished by diverting bypass circuits from the traditional regulated medical waste (RMW) to clear bag waste, or municipal solid waste (MSW). To qualify circuits to be disposed of through MSW stream, the circuits needed to be void of any free-flowing blood and be "responsibly clear." Traditionally the perfusion bypass circuit was emptied through the cardioplegia pump starting shortly after decannulation and heparin reversal. Up to 2000 mL of additional prime solution was added until the bypass circuit was rinsed clear. Three hundred sixty of 400 procedures (90%) had a complete circuit rinse and successful diversion to MSW. An additional 240 mL of processed cell salvage blood was available for transfusion. No additional time was spent in the operating room as a result of this procedure. Based on our procedure case volume and circuit weight of 15 pounds, almost 15,000 pounds (7.5 tons) of trash will be diverted from RMW. This technique represents another way for perfusionists to participate in sustainability efforts. Diverting the bypass circuit to clear bag waste results in a reduced environmental impact and annual cost savings. The treatment of RMW is associated with various environmental implications. MSW, or clear bag waste, on the other hand can now be disposed of in waste-to-energy facilities. This process not only releases a significantly less amount of carbon dioxide into the environment, but also helps generate renewable energy. Therefore, the bypass circuit diversion pilot project effectively demonstrates decreases in the carbon footprint of our organization and overall operating costs.
该项目的目标是减少废物处理量、成本,并将受监管的废物处理和处置对环境的负面影响降至最低。这是通过将旁路回路从传统的受监管医疗废物(RMW)转移到透明袋废物或城市固体废物(MSW)来实现的。为了使回路有资格通过城市固体废物流进行处置,回路需要没有任何自由流动的血液并且“清洁无污染”。传统上,灌注旁路回路在拔除插管和肝素逆转后不久就通过心脏停搏液泵排空。添加多达2000毫升的额外预充溶液,直到旁路回路冲洗干净。400例手术中有360例(90%)进行了完整的回路冲洗并成功转移到城市固体废物处理。另外还有240毫升处理过的细胞回收血液可供输血。由于该操作,手术室没有额外花费时间。根据我们的手术病例数量和15磅的回路重量,将近15000磅(7.5吨)的垃圾将从RMW中转移出来。这项技术是灌注师参与可持续发展努力的另一种方式。将旁路回路转移到透明袋废物可减少对环境的影响并节省年度成本。RMW的处理与各种环境问题相关。另一方面,城市固体废物或透明袋废物现在可以在垃圾转化能源设施中进行处置。这个过程不仅向环境中释放的二氧化碳量显著减少,还有助于产生可再生能源。因此,旁路回路转移试点项目有效地证明了我们组织的碳足迹和总体运营成本的降低。