Episode 055 | May 8, 2023 | 53:50
Guest: Jannik Jensen
Published: May 8, 2023
Duration: 53:50
Description
Joachim Almdal and Jannik Jensen, Global Product Manager at Medclair, explore ways to reduce CO2 emissions while using nitrous oxide and anesthetics in medical procedures. Nitrous oxide is a potent greenhouse gas; Jannik discusses how to capture and destroy it.
Full transcript
About this transcript
This transcript was automatically generated and may contain inaccuracies, typos, or mistranslations. Episodes recorded before 2024 were transcribed by an on-site model and may have a higher error rate. The content reflects the original conversation to the best of our ability. For the authoritative version, please listen to the audio episode.
Midwives are limited in what they can offer for pain because many pharmaceuticals also affect the baby. That’s why the nitrous-oxide program — easy for the woman to adjust, mask on, mask off. But it leaves a footprint. Thank god it’s not delivered as a free-flow system — for the climate and staff safety that would be a concern.
Hello and welcome. Today Jannik from Medclair joins us. Nitrous oxide (laughing gas) is used widely in healthcare and is a big CO2 emitter. Medclair has a solution to mitigate it.
Jannik’s background: ICU nurse for 10 years at Copenhagen University Hospital. In 2008 a global gas company hired me to educate staff worldwide on nitrous oxide. Visiting Swedish hospitals around 2008, they told me “Mr Jensen, don’t mention it — we destroy it.” They took me to a basement and showed me what looked like an oversized fridge — actually a destruction device. Today all Swedish hospitals have these installed. Swedish politicians started focusing on this in 2004. Clinicians argued they needed it; the politicians said find a solution or terminate it.
Anesthetics account for ~5% of healthcare CO2. The highest-footprint items get targeted first. Nitrous oxide global warming potential is 273-300x CO2.
Two types of anesthetics: IV and gases. We focus on gases. Nitrous oxide is used with oxygen, never 100% alone — pain relief + light sedation, but not full sleep, you need another drug for that. Common in dentistry and in births.
In Denmark: all 21 maternity wards offer the nitrous oxide program. 80% of women raise their hand for pain relief during birth. Midwives can adjust easily — woman holds the mask herself, removes if uncomfortable. Long use leaves a heavy footprint. Mask on / mask off for 4 hours of intimate use is equivalent to driving a gasoline car 1,400 km.
How it’s delivered: not as free flow (good for staff safety and climate). Demand-driven flow like scuba gear — patient gets gas only on inhalation. Midwives titrate 50%/25% mixtures with oxygen. Exhale into the same mask — staff capture it for their own safety. Historically the captured gas goes to the ventilation system unfiltered, straight to the atmosphere.
Medclair’s technology: redirect the captured exhale pipe from the ventilation to a central destruction system. We promise 95%+ destruction. Catalyst + heat splits N2O into N2 + O2 — room air.
Danish case: a Copenhagen hospital with 14 delivery rooms — biggest maternity in Denmark, 7,000 births/year. They installed the nitrous oxide program first (women were Googling and selecting hospitals that had it). Year two they installed the Medclair central destruction system. Total system ~200,000 euros, lasts at least 10 years. Per-patient cost just over 3 EUR. After a couple of months running: 57 tons of CO2 destroyed; expected ~500-600 tons per year.
Beyond maternity: emergency departments, paediatric, orthopaedic, endoscopy — many use it. The UK NHS uses nitrous oxide widely but ~85% of UK hospitals don’t capture the exhale gas — both staff-safety and climate concerns. They’re now focusing on both.
Sustainable workforce angle: we’re short-staffed in healthcare (Denmark needs 5,000 more nurses). Nitrous oxide programs can fast-track patients who don’t need full general anesthesia — relieving the workload on anesthetic doctors and nurses. The Copenhagen hospital is now asking for mobile destruction units to extend the program safely to other departments.
UK uses nitrous oxide self-administered for endoscopy (painful procedure); Denmark went the propofol-by-NAPS (nurse-administered propofol sedation) route. Different approaches.
Arguments against destroying nitrous oxide? Investment costs money. Otherwise no. Climate solution + saving money + fewer general-anesthesia patients = no-brainer.
On reuse / loop: we capture about 80% of exhale; destroy 95% of that. The unused 20% remains a climate concern. The cylinders themselves are returned to the gas manufacturer not fully empty (UK studies say ~25% remains) — and currently those leftover gases are vented to atmosphere except in Stockholm where they go through destruction. Cannot reuse pharmaceuticals, regulatory. Closed-loop hasn’t been invented.
Find Medclair: medclair.com, on LinkedIn / YouTube / Twitter / Instagram. Jannik Jensen on social.
Thanks Jannik. Thanks for listening — please subscribe and share.