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2134 Evidence based medicine – a FORCE for environmental sustainability
  1. Rebecca Hewitson1,
  2. Kundai Rukambiro1,
  3. Stacey Harris1,
  4. Rosie Hillson2,
  5. Jordan Evans1,
  6. Andora Webster1
  1. 1University Hospital of Wales, Cardiff, UK
  2. 2Centre for Sustainable Healthcare


Aims and Objectives After reading the FORCE publication our hospital set out to adopt the suggestions of the study and manage torus or ‘buckle’ fractures with the offer of a bandage instead of a wrist splint. The full FORCE study report includes detailed health economic results but it struck us that this change could also contribute to a carbon net zero NHS. This is an issue of great significance to both children and young people and clinicians.

We wanted to evaluate the potential carbon benefit of this change in practice and sought the expertise of the Centre for Sustainable Healthcare to assess the carbon count for both treatment options.

Method and Design The carbon footprint of the bandage and the splint were estimated using a cradle-to-grave process-based carbon footprinting analysis, looking at the extraction of raw materials, transport (country of manufacturing to the UK) and disposal.

Results and Conclusion The carbon count of a wrist splint (Promedics wrist splint) was found to be 0.967 kgCO2e whilst that of a bandage was 0.038 kgCO2e, meaning a carbon reduction of 0.929613 kgCO2e per patient. As it is estimated that there are approximately 60,000 annual presentations to UK Emergency Departments with buckle fractures of the wrist this would equate to a potential reduction of 55,777 kgCO2e (56 tonnes CO2e). To put this into context on average a tree absorbs in the region of 25 kgCO2e a year, therefore to offset the use of splints instead of a bandage more than two thousand trees would need to be planted.

The FORCE team demonstrated that treatment with a bandage had a lower financial cost for families and the NHS and our evidence suggests a lower carbon cost too. We believe this obligates those caring for children and young people in the emergency department to explore making such a change for their population.

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