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A clear method of communication between and within theatre teams, including related areas, e.g. obstetric or paediatric wards, should be in place concerning the urgency category of an emergency, escalation and who to contact.⁴⁷

The World Health Organization checklist must be completed for all patients undergoing surgical or invasive procedures.  An appropriate review prior to surgery, e.g. a ‘stop moment’, should be used.^{4, 33,170,188,189}

Safety requires a combination of checklists, teamwork and human factors.  'Checklists must be conducted by teams of healthcare professionals who have trained together and who have received appropriate education in the human factors that underpin safe teamwork.'²⁵

There should be a documented policy for the transfer of patients requiring anaesthetic supervision and care, including any additional requirements for transfers to another geographical site.⁷⁸

There should be a clear process in place for the referral of patients requiring critical care, including paediatric patients, to an appropriate facility.^8,73,183

The following policies should be immediately and reliably available at sites where anaesthesia and sedation are provided:

• guidelines for the management of anaesthetic emergencies including guidelines for children
• difficult airway management including ‘can’t ventilate’, and ‘can’t intubate’^94,192

Operating lists should include the patients’ weight and body mass index (BMI), and the World Health Organization (WHO) Surgical safety checklist³⁶ should include obesity related issues such as correct equipment and manual handling.³⁵

​​​​​​The following policies should be held and easily accessible along with those outlined in chapter 3:

• infection control (including antibiotic prophylaxis, staff protection and post-exposure prophylaxis)¹⁹⁰
• an escalation plan for theatre capacity and staffing, including a locally agreed policy for the deferment of elective activity to accommodate emergency surgical activity when required³
• clear guidelines on whom to...

Hospitals should have policies for the management of the airway in emergency situations, which should include fasting times, preanaesthetic assessment of the airway, availability and maintenance of the equipment and training of staff.^94,192

Hospitals should have guidelines for the safe extubation of patients following emergency anaesthesia.