To maintain the necessary repertoire of skills, consultant anaesthetists and SAS doctors providing a head and neck service should have a regular commitment to the specialty. Adequate time should be made available for them to participate in a range of relevant continuing medical education activities, including simulation, human factors and team training.7,43,44
Appropriately trained healthcare workers monitoring patients who have undergone regional anaesthesia should be specifically trained with their competencies clearly defined according to the Association of Anaesthetists’ requirements for post-anaesthesia care unit (PACU) recovery nursing.29 This individual should be able to recognise symptoms and signs of local anaesthetic toxicity.25
The experience and expertise of the anaesthetist assessing the patient preoperatively should be appropriate for the complexity and level of risk of the patient.46 The decision to operate on high-risk patients should be made at a senior level, involving surgeons and those who will provide intra and postoperative care.4,5,19
Families should be provided with written or web-based resources that provide information specific to anaesthesia before the planned surgery/procedure,80 and contact details for the preassessment team should be provided in case they have further questions or need to speak directly with their anaesthetist. The leaflet ‘Information for teenagers, children and parents’ is available from the RCoA website, and...
If responsibility for care is transferred from one anaesthetist to another, a ‘handover protocol’ should be followed, during which all relevant information about the patient’s history, medical condition, anaesthetic status, and plan should be communicated.6
Routine anaesthesia monitoring according to the Association of Anaesthetists standards of monitoring should be available for all areas where anaesthesia is undertaken.102 Departments should follow national clinical guidelines for the use of monitoring equipment, or local guidelines when national guidelines are not available.
An anaesthetist should preoperatively assess all patients undergoing emergency surgery who require anaesthesia. This should take place outside of the theatre complex if possible and adequate time should be available for this to occur as clinical urgency allows.181
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
