[Ecological sustainability in prehospital emergency medicine : Analysis of the usage of medical consumables].

Abstract

Background: Despite the growing emphasis on ecological sustainability in healthcare, limited studies have addressed waste generation, reduction, reuse, and recycling strategies in time-critical preclinical emergencies.

Objective: In this study, we aimed to explore waste reduction opportunities in the packaging of nonsterile medical consumables and assess the recycling potential of packaging materials for sterile items in preclinical emergency medicine.

Methods: The packaging of medical consumables used by emergency medical services in the district of Gütersloh, North Rhine-Westphalia, Germany, was analysed for type, quantity and waste reduction and recycling potential following the 5R (reduce, reuse, recycle, rethink, and research) approach. Originally, this concept was proposed for in-hospital waste management. The study covered the period 2018-2021. The district of Gütersloh, with a population of 370,000, is served by 22 ambulances and 5 physician-staffed ambulance vehicles across 10 rescue stations. The total material usage was analysed through the central material management system. The 10 most frequently used sterile and nonsterile medical consumables were identified, and their percentage relative to the total number of used items was calculated. Waste reduction potential was evaluated for nonsterile plastics packaged in plastic. The recycling potential of paper and plastic components from paper-plastic packaging of sterile medical consumables was assessed.

Results: Key waste reduction opportunities were identified for nonsterile consumables, including packaging of single-use patient blankets (n = 51,560; 35.3% of the total consumables), disposable sheets (n = 35,499; 24.3%) and oxygen masks (n = 10,834; 7.4%). For sterile products, recycling potential was found in the packaging of syringes (n = 44,745; 23.5% of the total consumables), infusion systems (n = 26,005; 13.7%) and intravenous catheters (n = 24,590; 12.9%). These items are packaged in a paper-plastic combination, where the paper and plastic components can be recycled separately, if uncontaminated.

Conclusions: Significant potential for waste reduction and recycling of preclinical emergency medicine packaging was identified, contributing to ecological sustainability. Sustainable workflow concepts should be developed. Further studies involving collaboration with hygienists and logistics experts are required to evaluate concepts and the feasibility of resource-saving workflows. However, resource conservation efforts must not compromise the quality of care provided to emergency patients.