AANA Issues Policy Considerations for the Management of Waste Anesthetic Gases

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American Association of Nurse Anesthesiology

Jun 12, 2024, 16:00 ET

ROSEMONT, Ill., June 12, 2024 /PRNewswire/ -- (AANA)— The American Association of Nurse Anesthesiology (AANA) recently issued its policy considerations addressing the safe and effective disposal of waste anesthetic gases (WAG).

"As we celebrate World Environment Day in June, these policy considerations outline the steps that highlight the role of Certified Registered Nurse Anesthetists (CRNAs) in managing the control of WAG exposure and what actions can be taken to improve our environment by minimizing WAG," says Cheryl Parker, DNP, CRNA, RNC-OB, FAWHONN, FAANA. "These policy considerations feature the most up-to-date resources for facilities that utilize inhaled anesthetic agents and for healthcare providers who may be exposed to WAG."

Uncontrolled exposure to WAG may lead to adverse health effects in anesthesia staff, patients, and visitors so it is important to limit the venting of WAG into the healthcare environment. Potential health effects of exposure to WAG include nausea, dizziness, headaches, fatigue, and irritability, as well as liver and kidney disease.

CRNAs, also known as nurse anesthesiologists or nurse anesthetists, work in locations including operating rooms and post-anesthesia care units. Hence they face increased exposure to WAG. Healthcare facilities where general anesthesia is administered are required to ensure that the vacuuming and ventilation system is effective and routinely maintained.

According to a 2011 National Institute for Occupational Safety and Health (NIOSH) survey of anesthesia professionals, the use of ventilation or scavenging systems is nearly universal. However, variability exists with respect to adherence to other recommended practices and differs among those administering adult or pediatric anesthesia. To address this, the policy considerations contain a check list for anesthesia providers, facility biomedical engineers, and healthcare facility administrators for limiting WAG exposure.

As healthcare facilities develop their WAG policies, CRNAs are uniquely positioned to consult with their facility biomedical engineers and review relevant local, state, and federal laws, regulations, and other professional organizational standards to determine acceptable WAG ranges and the frequency of monitoring hazardous gases and vapors. This collaboration during the development of WAG policies can help determine the appropriate air exchange levels within a facility and mitigate exposure to these gases.

CRNAs should verify that appropriate safety precautions are in place in all locations where they work, including non-operating rooms or office-based practices, to limit WAG exposure. This includes making sure the anesthesia machines and breathing circuits are properly maintained and the selection of anesthetic gases with lower environmental impact should be considered. "Research shows that the atmospheric lifetimes, global warming potential and ozone depleting potential of anesthetic gases reinforce their negative impact on climate change. CRNAs should be aware of the new technologies and opportunities to implement new innovations for positive environmental impact into their practice," said Parker.

SOURCE American Association of Nurse Anesthesiology