Nicole Jackman

CNI Fellow - Class of 2015

Graduate Student, Anesthesiology
UC San Francisco


Efficient Use of Fresh Gas Flow With Inhaled Anesthetics Can Decrease Costs and Impact Medical Greenhouse Gas Emissions at UCSF


Inhaled anesthetics are greenhouse gases routinely used for general anesthesia. Total fresh gas flow used to administer anesthetic gases determines the proportion of inhaled gases that enters the atmosphere. In order to promote the efficient use of inhaled gases, data must be collected on current practice patterns. This information is now incorporated into our electronic medical record. Our goal is to decrease volatile agent consumption and resultant purchasing costs to UCSF.


  • Recording of fresh gas flow in electronic medical record.
  • Reduction in fresh gas flows utilized by anesthesia providers.
  • Decreased spending on inhalational agents.
  • Increased awareness about the damaging environmental effects of common reagents used daily in our practice.

Future Plans

Expand to other hospitals. Personalized reports (gas usage by provider). Future Resident Incentive Project to continue to attempt to reduce fresh gas flows now that there is solid baseline data in the electronic medical record. Perhaps, use this data to facilitate discussion on different ventilators that show real-time data during delivery of anesthetic agents on efficient gas usage. May be important to departmental leadership when new machines need to be purchased.


Seema Gandhi