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Rapid and effective communication is one of the key components of good patient care. Communication strategies should consider the use of new technologies e.g. smart phones, and standardised methodology such as Situation, Background, Assessment, Recommendation (SBAR).174
Every department of anaesthesia undertaking emergency surgery should appoint a senior clinical lead (see glossary) with adequate provision within their job plan and support to develop and lead emergency anaesthesia within the organisation.33 This role could include liaison with other departments.
The anaesthetic clinical lead for emergency anaesthesia should be part of a multidisciplinary team with access within the governance structure to trust board level, with explicit pathways of communication.
There should be clarity of leadership and roles to supervise the day to day running of emergency theatres and the emergency anaesthesia service. Those undertaking these roles should be clearly identifiable to all working that day and easily accessible at all times.
Information on the long-term effects of anaesthesia, particularly for infants and young children should be made readily available to parents and guardians.26,16
The theatre booking system should enable the identification and prioritisation of high risk cases. Priority of access should be given to emergency patients over elective patients.3,20,42,175 There should be a clear policy for cancelling elective surgery to enable additional emergency theatre provision.13
The role of an ‘emergency theatre co-ordinator’ should be considered for departments with a large emergency workload, so that patient flow and prioritisation of cases can be actively managed.176
A current list of emergencies should be easily accessible to all medical and operating department staff, so that there is shared awareness of the emergency load and resource requirements, within the principles of patient confidentiality.177,178
The urgency of emergency cases should be clearly and unambiguously coded.14 There should be regular review of delays to facilitate improved theatre access and to promote accurate urgency coding at booking. Prioritisation of cases based on their urgency is not the sole domain of any single specialty. It requires a team approach involving discussion between different surgical groups, anaesthetists...
The language in all communications relating to the scheduling and listing of procedures must be unambiguous. Laterality must always be written in full, i.e. ‘left or ‘right’.25
