If a patient is transferred to the recovery unit with a tracheal tube in situ, the anaesthetist remains responsible for the removal of the tube but may delegate its removal. Delegation should be to an appropriately trained member of staff who is prepared to accept this delegated responsibility.180
If responsibility for care is transferred from one anaesthetist to another, a ‘handover protocol’ should be followed, during which all relevant information concerning the patient’s medical history, medical condition, anaesthetic status, and plan should be communicated.182
The anaesthetist should invite and answer questions from the patient or, if appropriate, the patient’s relatives.
The anaesthetist should be part of a burns multidisciplinary team.11
The duty anaesthetist should be informed as soon as a woman with a BMI above a locally agreed threshold is admitted.
An anaesthetist should be involved in all case reviews where the case includes anaesthetic input.
There should be a nominated anaesthetist responsible for training in regional anaesthesia, with adequate programmed activities allocated for these responsibilities.
All pregnant women requiring caesarean birth should, except in an extreme emergency, be visited and assessed by an anaesthetist before arrival in the operating theatre. This should allow sufficient time to weigh up the information to give informed consent for anaesthesia.137
Anaesthetists who prescribe oral sedation for paediatric burn patients do not need to be physically present for the procedure for which sedation is being prescribed but they, or other suitably trained and experienced staff, need to be available to return immediately if the need arises.53
Anaesthetists with commitments to regional and national work should have appropriate support through job planning. Departments should take into consideration both the impact this has on the rest of the department, as well as the considerable benefits local departments gain from having staff undertake anaesthetic regional and national roles.
