Cardiothoracic anaesthetists should be familiar with the normal physiological effects of pregnancy and the general principles of obstetric anaesthesia.
The anaesthetist should consider all environmental factors when planning administration of anaesthesia or sedation.
Anaesthetists with an appropriate level of training should manage patients undergoing major elective vascular surgery.
Nationally agreed key performance indicators should be used to monitor the performance of the pathways for hip fractures and major trauma and reviewed by a multidisciplinary committee including a trauma lead anaesthetist. In addition, local quality indicators should be developed proactively, to support continuing improvement of these services within organisations.
Anaesthetists should always be supported by dedicated, appropriately skilled and trained assistants. Recovery facilities should be staffed during all operating hours and should have appropriate anaesthesia support until the patient meets agreed discharge criteria.12
All anaesthetists should complete training in adult and paediatric life support, safeguarding and consent, appropriate to their clinical practice and case load (emergency as well as elective). Knowledge and skills in these domains should be maintained through CPD and planned as part of annual appraisal and personal development plans (PDP).
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
