Search

All women requiring caesarean section should, except in extreme emergency, be visited and assessed by an anaesthetist before arrival in the operating theatre. This should be timed to allow women sufficient time to weigh up the information they have been given, in order to give informed consent for anaesthesia.

Each hospital should have a multidisciplinary committee for paediatric care to formulate and review provision. This committee should involve anaesthetists, paediatricians, surgeons, emergency department representatives, senior children’s nurses, managers and other professionals, such as paediatric pharmacists. In some hospitals, this will also include PICU physicians.

Major trauma patients arriving in the ED of MTCs and TUs should be met by a multidisciplinary team 24/7. An anaesthetist with appropriate airway and damage control resuscitation competencies to manage trauma patients should be part of this team.^{6, 7}

Anaesthesia for the emergency control of major traumatic haemorrhage, and other damage limiting interventions in the operating theatre or radiology intervention suite, should be consultant anaesthetist led. Where consultants are not resident, clear lines of communication and notification should be in place to allow early attendance to trauma calls.

All anaesthetists involved in the management of major trauma should understand the principles and techniques of damage control resuscitation to prevent lethal triad of hypothermia, acidosis and coagulopathy using low volume fluid resuscitation, blood products and damage control surgery.⁷

There should be a minimum of one member of the recovery staff, or an anaesthetist, with advanced training in paediatric life support on duty and all members of recovery staff should have up-to-date paediatric competencies including resuscitation.¹⁰

AAs should always work within an anaesthesia team led by a consultant anaesthetist who has overall responsibility for the anaesthesia care provided for the patient and whose name should be recorded in the individual patient’s medical notes.¹¹²

All anaesthetists with a job plan including sessions in non-theatre anaesthesia should be able to demonstrate continued competency through maintenance of an appropriate level of experience, and ongoing participation in relevant continuing professional development.^1,57

All institutions where sedation is practised should have a sedation committee. This committee should include key clinical teams using procedural sedation and there should be a nominated clinical lead for sedation. In most institutions, the sedation committee should include an anaesthetist, at least in an advisory capacity.

There should be an appropriately trained theatre team including an on-call consultant or other autonomously practicing anaesthetist 24/7 to provide anaesthesia for emergency head and neck surgery in head and neck cancer centres and in hospitals with an emergency department (ED).⁹