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Clinical observations should be supplemented by pulse oximetry and non-invasive blood pressure monitoring until the patient is fully recovered from anaesthesia. An electrocardiograph, nerve stimulator, thermometer, glucometer and capnograph should also be readily available.^6,16,17

A patient’s consent to participate in research projects should be obtained by those conducting the study and not by the anaesthetist providing care for the operation. Consent should be obtained on a separate signed document and approval should be sought from the anaesthetist who will be delivering the anaesthetic to the patient.^79,81

It may be difficult to make the electrocardiogram (ECG) gel electrodes adhere to damaged skin. ECG electrodes could be sited away from the chest22 or could be attached to crocodile clips, surgical staples or steel sutures placed in burned areas.^15,19,24

Children currently transition to adult congenital heart disease services at the age of 16–18 years, although transition services are integrated into the care pathway from age 12 years. Anaesthetists should be aware of legislation and good practice guidance relevant to young and vulnerable adults.^45,51

Where children are transferring from paediatric to adult services there should be the opportunity to advise them about possible changes in anaesthesia management. Examples may include the use of sedation for some procedures that previously would have been managed with general anaesthesia, or the use of alternatives to topical anaesthesia.³³