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ecause its decisions affect
nearly every area of op-
eration, supply chain has
major potential for greening
healthcare. But getting a sus-
tainability plan in place can be challenging.
That’s why industry experts developed the
Sustainability Roadmap for Hospitals.
The Sustainability Roadmap is a national
clearinghouse of comprehensive informa-
tion about healthcare sustainability geared
specifically to healthcare professionals and
backed by industry and community leaders.
Designed to help healthcare organizations
recognize and act on the need to promote sus-
tainability in their practices, the roadmap is a
free online repository of resources, tools and
information, and can be a great platform for
sustainability efforts in all healthcare settings.
Framing the Issue
With such a significant carbon footprint,
the healthcare industry presents many op-
portunities to green the system and make
a real impact on the health and environ-
ment of local communities. Many supply
chain professionals balk at making policy
and product changes in the face of budget
constraints, but sustainability efforts actu-
ally can make for a healthier bottom line.
Hospitals consume 2.5 times the energy
of other commercial buildings and spend
more than $8.7 billion annually, according
to the EPA Energy Star pro-
gram. The average hospital
provider spends more than
$72 million a year (one-
third of its annual operating
budget) on supply chain
functions alone. Ultimately,
the majority of materials
consumed in healthcare set-
tings becomes waste, the disposal of which
costs healthcare consumers $10 billion an-
nually. Strategic source reduction and waste
management afford supply chain profession-
als the ability to realize cost reductions as
high as 40 to 70 percent.
Using the Sustainability Roadmap
Aware that sustainability can be a daunt-
ing cause to champion, the American
Society for Healthcare Engineering
partnered with the Association for
the Healthcare Environment and the
Association for Healthcare Resource &
Materials Management (AHRMM) of the
American Hospital Association to develop
the Sustainability Roadmap for Hospitals
as a free, open-source online tool to help
hospitals reduce costs and achieve envi-
ronmental goals at the same time.
The website is organized so users can find
tools, case studies and evidence-based infor-
mation related to their specialties, including
facilities, energy, water, waste, supply chain
and chemicals. Information provided by the
roadmap is product-neutral so users have
access to reliable, unbiased resources. It in-
cludes information on incentives and policy
considerations, and provides tips for leading
a sustainability initiative replete with check-
lists and self-assessments that help hospitals
get started or take next steps. The roadmap
also provides the opportunity to participate
in discussions on sustainability topics and
report successes and experiences to others
working toward greener healthcare settings.
“The roadmap is a starting place and a
Facilities can follow roadmap for greater
hospital environmental sustainability
TOPICAL ANESTHETIC SPRAY
Brief Summary of the Prescribing Information
Tetracaine Hydrochloride ..................................................2.0%
Benzalkonium Chloride .....................................................0.5%
Cetyl Dimethyl Ethyl
In a bland water-soluble base.
The onset of Cetacaine-produced anesthesia is rapid (approximately
30 seconds) and the duration of anesthesia is typically 30-60 minutes,
when used as directed.
Cetacaine is a topical anesthetic indicated for the production of
anesthesia of all accessible mucous membrane except the eyes.
Cetacaine is indicated to control pain and for use for surgical or
endoscopic or other procedures in the ear, nose, mouth, pharynx,
larynx, trachea, bronchi, and esophagus.
Dosage and Administration
Cetacaine Spray should be applied for approximately one second
or less for normal anesthesia. Only a limited quantity of Cetacaine
is required for anesthesia. Spray in excess of two seconds is
contraindicted. Average expulsion rate of residue from spray, at normal
temperatures, is 200 mg per second.
An appropriate pediatric dosage has not been established for
Dosages should be reduced in the debilitated elderly, acutely ill, and
very young patients.
Tissue need not be dried prior to application of Cetacaine. Cetacaine
should be applied directly to the site where pain control is required.
Anesthesia is produced within one minute with an approximate
duration of thirty minutes. Each 200 mg dose of Cetacaine Spray
residue contains 28 mg of benzocaine, 4 mg of butamben and 4 mg of
Hypersensitivity Reactions: Unpredictable adverse reactions (i.e.
hypersensitivity, including anaphylaxis) are extremely rare. Localized
allergic reactions may occur after prolonged or repeated use of any
aminobenzoate anesthetic. The most common adverse reaction caused
by local anesthetics is contact dermatitis characterized by erythema
and pruritus that may progress to vesiculation and oozing. This occurs
most commonly in patients following prolonged self-medication, which
is contraindicated. If rash, urticaria, edema, or other manifestations
of allergy develop during use, the drug should be discontinued. To
minimize the possibility of a serious allergic reaction, Cetacaine
preparations should not be applied for prolonged periods except under
continual supervision. Dehydration of the epithelium or an escharotic
effect may also result from prolonged contact.
Precaution: On rare occasions, methemoglobinemia has been reported in
connection with the use of benzocaine-containing products. Care should
be used not to exceed the maximum recommended dosage (see Dosage
and Administration). If a patient becomes cyanotic, treat appropriately to
counteract (such as with methylene blue, if medically indicated).
Use in Pregnancy: Safe use of Cetacaine has not been established with
respect to possible adverse effects upon fetal development. Therefore,
Cetacaine should not be used during early pregnancy, unless in the
judgement of a physician, the potential benefits outweigh the unknown
hazards. Routine precaution for the use of any topical anesthetic should
be observed when Cetacaine is used.
Cetacaine is not suitable and should never be used for injection.
Do not use on the eyes. To avoid excessive systemic absorption,
Cetacaine should not be applied to large areas of denuded or inflamed
tissue. Cetacaine should not be administered to patients who are
hypersensitive to any of its ingredients or to patients known to have
cholinesterase deficiencies. Tolerance may vary with the status of the
patient. Cetacaine should not be used under dentures or cotton rolls, as
retention of the active ingredients under a denture or cotton roll could
possibly cause an escharotic effect. Routine precaution for the use of
any topical anesthetic should be observed when using Cetacaine.
Rx Only. Made in U.S.A.
© 2013 Cetylite Industries, Inc. All rights reserved. Information is summary in nature and subject
to change. Cetacaine and Cetylite are registered trademarks of Cetylite Industries, Inc. All other
copyrights are the property of their respective owners.
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the energy of other
commercial buildings and
spend more than
Continued on page 18
Fourth Quarter 2013 | The Source 15
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