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Introduction

Cardiac anaesthesia services are provided for patients undergoing cardiac procedures. To reflect current practice, these guidelines have been more clearly divided to identify areas of differing requirement. Anaesthetists in cardiac surgical services are now more frequently required to provide anaesthesia for invasive cardiology procedures in the catheter laboratory. Intraoperative transoesophageal echocardiography is a specialist skill that cardiac anaesthetists are...

Introduction

Thoracic anaesthesia services are provided for patients undergoing thoracic procedures. To reflect current practice, these guidelines have been more clearly divided to identify areas of differing requirement.

Thoracic surgery may include surgery on the lungs (including lung transplantation), pleura, thymus, oesophagus and other thoracic structures, as well as the chest wall. Less invasive video assisted surgery is now mainstream...

Introduction

The Guidelines for the Provision of Anaesthetic Services (GPAS) supports the development and delivery of high quality anaesthetic services. The ACSA scheme supports departments of anaesthesia to implement the recommendations contained within GPAS. This is achieved through a set of standards, derived from GPAS, against which a department is able to benchmark itself through self-assessment and peer review.

GPAS...

Introduction

Cardiothoracic anaesthesia services are provided for patients undergoing cardiac and thoracic procedures. To reflect current practice, these guidelines have been more clearly divided to identify areas of differing requirement. Anaesthetists in cardiac surgical services are now more frequently required to provide anaesthesia for invasive cardiology procedures.

Cardiac surgery

Cardiac surgery may involve adult, paediatric and neonatal patients and includes...

Introduction

Inpatient pain services (IPS) consist of a multidisciplinary team including appropriately trained acute pain physicians and anaesthetists along with nurses specialised in pain management. Other allied health professionals such as applied psychologists, addiction medicine specialists, physiotherapists and pharmacists may also be part of the IPS team.

After the publication of the joint working party of the Royal College of...

Introduction 

From their inception, IPS have provided acute post-surgical pain management to promote a balance of symptomatic relief and early restoration of function to improve patient experience and surgical outcomes. An ongoing and important role of the IPS is the consistent training and education of staff and students across the wider hospital trust. Other responsibilities continue to expand into...

Introduction

Trauma remains the most common cause of loss of life in the under 40s age group in the UK, and as such major trauma centres (MTCs) and trauma units (TUs) have been established to receive patients of all ages and to improve outcomes.¹ Early anaesthetic involvement is beneficial at all stages, from the prehospital setting, to emergency departments...

Introduction 

There are increasing numbers of diagnostic and therapeutic procedures performed outside the main theatre environment, in both elective and emergency situations. These procedures may require anaesthetic involvement through haemodynamic monitoring during the procedure, sedation, regional anaesthesia or general anaesthesia. The challenge for anaesthesia is to develop a framework that supports and regulates the safe delivery of care.

Commercial and...

Introduction

The range of procedures requiring anaesthesia for burn and plastic surgery is wide and includes patients of all ages. Procedures range from common minor injuries (dog bites, nail bed injuries) to planned congenital cleft lip and palate and hand procedures, and less frequently major burns and free-flap surgeries requiring multidisciplinary perioperative critical care. The recommendations in this chapter should...

Introduction

Head and neck surgery includes a wide spectrum of surgical interventions, ranging from short daycase procedures to long and complex operations.¹ The requirements for providing anaesthesia services for routine head and neck surgery, such as tonsillectomy, will be different to those required to provide anaesthesia for major or complex surgery. There should be recognition that routine head...