{
  "abstract": "Aims and Objectives This QIP is to demonstrates that substituting Entonox with Penthrox for painful procedures in the Emergency Department can maintain high quality pain relief while achieving a 100-fold reduction in carbon emissions, integrating sustainability directly into frontline practice.Pain associated with trauma is one of the most common reasons for Emergency Department (ED) attendance and it is often undertreated. Entonox (nitrous oxide) is effective but carries approximately 98.9 kg CO 2e per administration. Penthrox (methoxyflurane) gives equal or greater analgesia with only 0.84 kg CO2e per administration (118 times lower).The aim is to reduce or replace Entonox use by implementing Penthrox for adult patients undergoing painful procedures, while supporting sustainability objectives.Method and Design An SOP for use of Penthrox was created and implemented in the ED for painful procedures. Comprehensive staff training was offered using face to face and online modules. Post implementation data was collected to evaluate uptake, prescribing patterns, outcomes in procedures, and environmental impact.Results and Conclusion A total of 21 procedures were captured within the first month. The age range was wide (19-78 years) with almost equal gender distribution. There were no recorded adverse effects. This equated to a net reduction in CO2 emissions from a potential 2077 kg CO 2e to only 17.64 kg CO2e and a significant carbon emission reduction.The introduction of Penthrox in the Emergency Department provides effective, rapid, and sustainable pain management in the ED, aligning clinical care improvements with environmental responsibility. This initiative demonstrates that improving patient care can be successfully aligned with the NHS’s commitment to reducing carbon emissions and promoting green clinical practices.",
  "authors": [
    {
      "affiliations": [
        "Royal Liverpool Hospital"
      ],
      "name": "Tess Sanders"
    },
    {
      "affiliations": [
        "UCLH"
      ],
      "name": "Dipak Mistry"
    }
  ],
  "title": "3631 Improving the experience of the neurodivergent patient in the emergency department: a quality improvement project",
  "uid": "48716203-2fab-541f-b090-389e70bee727"
}