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Online people. Can you hear now? Can you type in the box if you can? Doesn't look like? Yes, perfect, sorry, sorry for that. Ok, perfect. Ok. So just for the online people this this this is a talk on sustainable anesthetics. Um and we're just going I think hopefully, you know, see the slides, we're just going through some of the figures that have been um set as the targets for for um the NHS England um overall. So we're just looking at um the what we mean by a mega ton of carbon dioxide. So a mega to is like I said a billion um kilograms of carbon dioxide. So I dont some of you will notice a apology. Some of this talk might be very patronizing to some of you. So if you're looking at one second um mhm. And you compare it to 1000 seconds, 1000 seconds is 16.7 minutes, I'm just gonna ask you in your heads. I'm not gonna ask you to volunteer her out. How much do you think a million seconds would be? So a million seconds is 11.5 days. So when we go to a billion seconds, which is 1000 million seconds. So how many, how, how long would you think that is 31.6 years? Ok. So when we're looking at our are billions of carbon of carbon dioxide, it's, it's some of this is just incomprehensible, the amount that we have to save a bit like how much our billionaires have in money. But um it, you know, it is a vast, vast amount. Um it with this. So we've got to save 6.1 billion carbon dioxides just in the NHS bit, not in the NHS plus a bit. So, anesthetics um as you said on this um wheel, which again came out of that report, anesthetic gasses and meter dose inhalers um which are part of the community part rather than um you know, the hospital part um is five causes 5% of the NHS um carbon footprint. And when you look at the buildings and think the buildings actually are only 10% then 5% is actually a really significant amount. So again, totally patronizing for those who are either anesthetists or work in theaters or er O DPS. And so apologies, but some people won't have much of an idea of what an anesthetic um involves. So the word anesthesia that means loss of sensation. There are different types of anesthetic. We give a general anesthetic where you go to sleep, a local anesthetic. So something like you have for your teeth, um and for, you know, toenail removals or whatever like that, a regional anesthetic, which can involve local anesthetic to nerves or a nerve which will numb sort of like your leg or your arm or something. So, just very isolated numbness, a spinal or epidural anesthetic which involves injection in your back, um, will numb the lower part of your body sedation, which is just making you less conscious if you like and all combinations of all of them. OK. So we're gonna look specifically at a general anesthetic, which is a controlled unconsciousness if you like and controlled loss of sensation. So there's ways that we give a general anesthetic. There are two ways that we, we, we have an induction where we put you to sleep. We have a maintenance where we keep you asleep and then we have emergence when we stop all of those and you wake up, OK? Any of these things. So if we just gave you an injection into your vein. So I don't know if any of you have had an anesthetic, but we give you the propofol, which is the white stuff, we inject it into your vein. And if we were just to leave that and let you wake up, give you a bit of oxygen, wake you up, you'd probably wake up within about five minutes, something like that. You'd start moving around at about three minutes and start to wake up. So it doesn't keep you asleep for very long. Likewise, inhaling the anesthetic gasses, you breathe them in, you go off to sleep. We tend to use those in Children, but occasionally we use them in adults as well. They're, they're um the anesthetic gasses and volatile agents. And I'll explain to those in a minute. Um You breathe them in again. If we took them away, you would wake up very quickly. So then we have to have something to maintain the anesthetic. So we have to continue giving you something to keep you asleep, ok? And we can either do that. We do that in two ways. One is injecting an infusion of the same stuff that we put. You have to sleep by injecting. We put it into a syringe pump, a syringe driver and we give you a small amount throughout the whole um.