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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

Many head and neck cancer patients have significant comorbidities that may require optimisation prior to surgery. There should be a lead anaesthetist for preoperative assessment who works closely with an appropriate preoperative assessment team.¹²

Patients requiring head and neck procedures should be managed by anaesthetists who have had an appropriate level of training in this field and who have acquired the relevant knowledge and skills needed to care for these patients.^41,42

All anaesthetists must undertake at least level 2 training in safeguarding/child protection, and must maintain this level of competence by annual updates of current policy and practice and case discussion.^60,61 Safeguarding resources to support learning can be found on the RCoA website (www.rcoa.ac.uk/safeguardingplus).

The paediatric anaesthetist should consider the patient’s age and physical capacity, the complexity of the procedure and the status of the surgical facility before administering anaesthesia. Children with learning and/or communication difficulties requiring sedation or anaesthesia should be cared for as per the recommendations of GPAS Chapter 10: Guidelines for the Provision of Paediatric Services.³⁹