Reducing Nitrous Oxide Emissions Across the Melbourne Biomedical Precinct

Nitrous oxide (N₂O) accounts for the majority of Australian healthcare's direct anaesthetic gas-related greenhouse gas emissions due to reticulated system leaks. Updated Australasian guidelines no longer mandate a reticulated N₂O supply. We present the efforts of four Melbourne hospitals to reduce N₂O emissions across diverse clinical contexts. Two have decommissioned reticulated N₂O and adopted cylinder supplies as required through clinical consultation and interdisciplinary collaboration. Two face ongoing high clinical demand for N₂O, with multiple locations sharing infrastructure, and are pursuing audits and trials to guide change. These case studies illustrate the diverse strategies and challenges involved in reducing N₂O emissions.