Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Externado de Medicina Interna - ME212 - 202101

Curso de la carrera de medicina, de carácter teórico-práctico del ciclo 9, en el que los estudiantes presentan una historia clínica con su respectivo plan diagnóstico, terapéutico y de procedimientos en un paciente con una condición médica, a través de la realización de actividades de simulación y metodología activa. El curso del externado de medicina interna busca desarrollar la competencia general de comunicación escrita (nivel 3) y las competencias específicas de práctica clínica-diagnóstico(nivel 3) y profesionalismo-sentido ético y legal y responsabilidad profesional(nivel 3). El externado de medicina al estudiante le permitirá plantear un adecuado tratamiento y plan de trabajo según el diagnóstico de los principales problemas médicos que le servirá en su futura vida profesional