Our Mission

As our aging population grows, so does the prevalence of respiratory-related ailments. To meet this medical need, a variety of new respiratory diagnostic and treatment options are being developed. With the availability of these new options, respiratory care professionals will require the most up-to-date, scientifically- and clinically-based information to help them make informed decisions on what is best for their patients.

Clinical Foundations provides practical, clinically- and evidenced-based articles, case studies and symposia for respiratory therapists and respiratory care directors, managers, and supervisors. Clinical Foundations is based on a patient-focused model of care that emphasizes the need to provide the care and services that focus on patients’ individual needs and preferences.

As part of our commitment to helping respiratory care professionals improve their skills, each edition of Clinical Foundations is fully accredited by the AARC for CRCEs.

Current Issue

Waste Anesthetic Gases (WAGs) among Employees

in the Healthcare Industry

James D. McGlothlin, MPH, PhD, CPE and John E. Moenning, DDS, MSD

The scavenging of waste anesthetic gases (WAGs) is recommended by every professional organization and government agency involved with anesthesia to reduce occupational exposure to health care personnel.1 WAGs in health care environments have been associated with adverse health outcomes in unscavenged situations.2-21 Operating rooms and dental operatories have developed techniques to decrease occupational exposure by scavenging the WAGs and minimizing potential health problems, but few studies have addressed WAGs in the post-anesthetic care unit (PACU).22,23 Monitoring of WAGs, primarily nitrous oxide, has been done using dosimetry badges, hand-held monitoring devices, and infrared spectrophotometry. While these measuring devices give readings in the part per million (ppm) ranges, they cannot visualize the gas during or following administration to a patient. This can be important when determining leaks or direct exposure from patients exhaling residual levels of the anesthetic gases. Recent advances in infrared (IR) videography technology have made it possible to visualize nitrous oxide leakage. Because these leak sources can be readily identified from infrared imaging, the WAGs can be more easily controlled through the elimination of leaks, especially to scavenging systems, so that occupational exposures to personnel in the PACU are decreased. In this article, Drs. McGlothlin and Moenning presents a brief overview of WAGs in the healthcare industry, with a focus on healthcare personnel in the PACU. Recent exposure and risk assessment studies using IR thermography cameras and IR sensors to identify and quantify WAG (i.e., N20) exposures among PACU employees are pointing toward an unidentified and relatively new health exposure concern for these employees.61

Panel Discussion: Waste Anesthetic Gases:

Opinions from the Experts

Panelists: David Farr, MD, Joni Brady, MSN, RN, CAPA, Jim McGlothlin, MD

Waste anesthetic gases (WAGs) pose a significant health hazard in the hospital setting and must be controlled to protect healthcare workers. In this panel discussion, three experts discuss the scope of WAGs as an acute and chronic health hazard, both in the operating room (OR) and post-anesthetic care unit (PACU) settings, and review the many health conditions associated with excess exposure to WAGs. Also discussed are the many government guidelines and other publications that outline exposure limits and offer practical solutions to the problem.