An audit of potentially recyclable waste from anaesthetic practice.

Little is known about the amount of anaesthesia waste that is recyclable. We tested the hypotheses: 1) that anaesthetists produce a small proportion (< 10%) of total operating suite waste, 2) that much of this waste (> 30%) is recyclable and 3) that there is little (< 10%) cross-contamination of infectious and non-infectious waste. For five weekdays in a metropolitan hospital with six operating theatres, we weighed waste and determined the proportion of anaesthesia waste that was recyclable. Waste was routinely divided into general and infectious streams. For safety reasons the infectious waste was considered unavailable for recycling, leaving the general waste as potentially recyclable. Anaesthesia waste (90 kg) was 25% (95% confidence interval: 22 to 29%) of the total 357 kg of operating suite waste. Of 66 kg of general anaesthesia waste, 38 kg was recyclable (58%; 95% confidence interval: 47 to 67%). Most cardboard waste, however was included in the operating suite waste; therefore we under-estimated the total amount of recyclable anaesthesia waste. Of 24 kg of anaesthesia infectious waste, 2 kg (8%) was recyclable. The general waste contained 4 kg (7%; 95% confidence interval: 3 to 13%) of infectious items. No sharps were found. Anaesthesia waste was a quarter of total operating suite waste. Almost 60% of anaesthesia general waste could be recycled. Failure to eliminate infectious waste from general waste could be a barrier to recycling.

Communication failure in the intensive care unit--learning from a near miss.

A 51-year-old female patient with Guillain-Barré syndrome was given three times the intended dose of intravenous human immunoglobulin while admitted to a tertiary intensive care unit. The error went unnoticed for seven hours and appears to have been the result of several successive breakdowns in communication between key staff The patient, fortunately, made a full recovery. This report analyses the communication failure and explores possible ways of avoiding similar occurrences in the future.