Out with the old, in with the new and sustainable! Pre-filled syringes, a re-audit of use following introduction to our theatre complex

Abstract

Aim
With a move towards environmentally sustainable practice, we wondered if it would make both environmental and financial sense to use pre-filled syringes of Atropine and Suxamethonium. The first part of our audit cycle involved quantifying the number of ampoules of Atropine and Suxamethonium drawn up and discarded over a 16 day period in 2022, in our theatre complex. We found that the overwhelming majority were discarded. From this audit we made a case for the introduction of pre-filled atropine and suxamethonium syringes in our theatre complex, which were then introduced in January 2024. The aim of this audit was to calculate the cost benefit since the introduction of pre-filled syringes.

Methods
We placed a data sheet on each anaesthetic trolley in 9 theatres, to be filled out at the end of each week day, stating whether a pre-filled atropine or suxamethonium syringe had been used. We used the costing from our last audit to estimate the cost of the pre-filled syringes used.

Results
During the 16 day window, 1 pre-filled atropine syringe was used and no suxamethonium pre filled syringes were used. The cost of an atropine 500mcg/5mls pre-filled syringe is €7.90 and suxamethonium 100mg/10mls pre-filled syringe is €9.90. Suxamethonium pre-filled syringes expire after one month and are discarded. Despite this cost, when we extrapolated the data and compared it to the use of ampoules drawn up over the same period in 2022, we found a projected annual saving of approximately €2,223 with the use of atropine pre-filled syringes and approximately €7,485 with the use of suxamethonium pre-filled syringes. This would also prevent approximately 120 syringes and needles each week from contributing to environmental waste - 6,550 per year!

Discussion
It is our opinion that pre-filled syringes should be implemented across other hospital theatre complexes to lessen our carbon footprint, reduce costs, minimise human error and ensure sterility.