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Introduction

Neuroanaesthesia encompasses a wide range of emergency and elective work. Anaesthesia for intracranial oncology, vascular, hydrocephalus, trauma/neurotrauma, functional surgery, complex spinal surgery, as well as anaesthesia for diagnostic and interventional neuroradiological procedures, including MRI, all lie within the specialty.

Neuroanaesthesia is mainly delivered in neuroscience units, which may be based in specialist centres, teaching hospitals or district general hospitals...

Introduction

‘Emergency’ within this chapter applies to anaesthesia that is given in immediate (within minutes of a decision to operate) or urgent (within hours of a decision to operate) procedures as classified by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).

The provision of emergency anaesthesia differs from elective anaesthesia in that it is required 24/7. The demands...

Introduction

Regional anaesthesia (RA) is an important component of anaesthetic practice. It includes neuraxial and peripheral nerve block techniques which may be used for either perioperative anaesthesia or analgesia, as well as other non-surgical indications such as chronic pain and traumatic rib fractures. The practice of RA has changed significantly, particularly over the past three decades.¹ The introduction of...

Introduction

Infants, children, and young people have different requirements. There are marked developmental changes within the paediatric age range, and neonates, infants, and prepubertal children under the age of 8–12 years have particular anatomical and physiological differences. Doses of drugs and fluids need to be precisely calculated, and anaesthetic equipment for smaller children differs from that used in older children...

Introduction

The discipline of ophthalmic surgery encompasses the following areas: intraocular surgery, extraocular surgery, oculoplastic surgery, nasolacrimal surgery and orbital surgery. Ophthalmic surgery is undertaken in a wide variety of different settings, including multispecialty general hospitals, isolated units and large, single-specialty centres. All environments require appropriate staffing levels, skill mix and facilities. The ophthalmic anaesthetist has a key role in...

Introduction

Day surgery is the planned admission of a surgical patient for an elective or semi-elective procedure where the patient is admitted, undergoes surgery and is discharged on the same calendar day.² If the patient remains in a hospital bed overnight on the day of their surgery they are classed as having undergone inpatient surgery. The term ‘23-hour stay’...

Introduction

Vascular  services are recognised as having a high priority in the UK. Publication of evidence that the outcome from abdominal aortic aneurysm (AAA) surgery was significantly worse in the UK than in comparable countries,¹ and the 2005 NCEPOD Report ‘AAA a service in need of surgery’, led to a national Abdominal Aortic Aneurysm Quality Improvement Programme (AAAQIP)...

Introduction

It is nearly two decades since it was widely reported that the outcome from abdominal aortic aneurysm (AAA) surgery was significantly worse in the UK than in comparable countries.¹ The 2005 NCEPOD report Abdominal Aortic Aneurysm: A service in need of surgery² subsequently led to a national Abdominal Aortic Aneurysm Quality Improvement Programme (AAAQIP) being introduced...

Introduction

Day surgery is the planned admission of a surgical patient for a procedure where the patient is admitted, undergoes surgery and is discharged on the same calendar day.¹ If the patient remains in a hospital bed overnight on the day of their surgery they are classed as having undergone inpatient surgery. The term ‘23-hour stay’ surgery is short-stay...

Introduction

Pregnancy and childbirth remains a risky time for both mother and baby. In recent years, we have seen the maternal mortality rate plateau.^7,8,9 

However, the confidential review of every maternal death over the past seven decades continues to identify that substandard care, frequently caused by deficiencies in service provision, has led to avoidable...