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[麻醉科可重复使用设备的优先使用与再处理:关于如何减少麻醉设备碳排放的建议]

[Prioritized utilisation and reprocessing of reusable equipment in anaesthesiology deparmtents : Recommendations on how to reduce CO emissions from anaesthetic equipment].

作者信息

Richter Hannah, Schulz-Stübner Sebastian, Pecher Sabine, Orlowski Stefan, Coburn Mark, Schuster Martin

机构信息

Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Kliniken Landkreis Karlsruhe, Fürst-Stirum-Klinik Bruchsal, Rechbergklinik Bretten, Akademische Lehrkrankenhäuser der Universität Heidelberg, Gutleutstr. 1-14, 76646, Bruchsal, Deutschland.

Nachhaltigkeit in der Anästhesiologie, Forum der DGAI und des BDA, Nürnberg, Deutschland.

出版信息

Anaesthesiologie. 2023 Jun;72(6):433-444. doi: 10.1007/s00101-023-01268-2. Epub 2023 Mar 17.

DOI:10.1007/s00101-023-01268-2
PMID:36930267
Abstract

Currently, few robust data are available to provide estimates of the environmental footprint and in particular the CO emissions of medical devices; however, existing life cycle assessments largely indicate that reusable materials have more favorable emissions and environmental footprints compared to disposable items. Thus, the challenge for every anesthesiology department is to identify items that can be used as reusable products for ecological and other reasons.A prerequisite for the use of reusable items is hygienically correct reprocessing and packaging. Here, a distinction must be made between noncritical, semicritical and critical medical devices, depending on the type of use. In addition, a distinction must be made between categories A-C, depending on the complexity of the reprocessing.In this narrative review article common reusable items used in anesthesiology are categorized and a standardized decision algorithm for reprocessing routes is proposed. Special attention is also given to the packaging of medical devices, which can contribute to the ecological footprint to a relevant extent.This article further explains the framework under which reprocessing can take place and analyzes the current state of knowledge on the life cycle assessment of reprocessing reusable devices.This requires the special commitment of clinically active anesthesiologists to include ecological aspects in the decision to use disposable or reusable items. In the medium term, comprehensible ecological key numbers should be provided on every medical device to make the ecological costs of the articles understandable in addition to the monetary costs.

摘要

目前,几乎没有可靠的数据可用于估算医疗设备的环境足迹,尤其是其二氧化碳排放量;然而,现有的生命周期评估大多表明,与一次性物品相比,可重复使用材料的排放量和环境足迹更有利。因此,每个麻醉科面临的挑战是确定出于生态和其他原因可作为可重复使用产品使用的物品。使用可重复使用物品的一个前提是进行卫生正确的再处理和包装。在此,必须根据使用类型对非关键、半关键和关键医疗设备进行区分。此外,还必须根据再处理的复杂性对A - C类进行区分。在这篇叙述性综述文章中,对麻醉学中常用的可重复使用物品进行了分类,并提出了再处理路线的标准化决策算法。还特别关注了医疗设备的包装,其在相当程度上会影响生态足迹。本文进一步解释了可进行再处理的框架,并分析了关于可重复使用设备再处理生命周期评估的当前知识状态。这需要临床活跃的麻醉医生做出特别承诺,将生态因素纳入使用一次性或可重复使用物品的决策中。从中期来看,应在每个医疗设备上提供易懂的生态关键数字,以便除了货币成本外,还能使物品的生态成本易于理解。

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