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A minimum of two members of staff should be present (of whom at least one should be a registered practitioner) when there is a patient in the PACU who does not fulfil the criteria for discharge to the ward. If this level of staffing cannot be assured, an anaesthetist should stay with the patient until satisfied that the patient fulfils...

Patients requiring planned or emergency burn surgery should be cared for by theatre staff with current experience in burn care.⁴ Anaesthetists who provide emergency care outside burn services should be trained to manage the initial treatment of the patient with severe burns, including timely emergency assessment, resuscitation and transfer to a burns service.

Patients requiring planned or emergency burn surgery should be cared for by theatre staff with current experience in burn care.⁴Anaesthetists who provide emergency care outside burn services should be trained to manage the initial treatment of the patient with severe burns, including timely emergency assessment, resuscitation and transfer to a burns service.

There must be the ability to provide the patient with an appropriate chaperone, as per General Medical Council (GMC) guidance on intimate examinations and chaperones.⁴⁹ When examining a patient, anaesthetists must be sensitive to what the patient may consider as intimate. This could include any examination where it is necessary to touch or even be close to the patient.

There should be a dedicated trained assistant (i.e. an ODP, anaesthetic nurse or equivalent) who holds a valid registration with the appropriate regulatory body, immediately available in every location in which anaesthesia care is being delivered, whether this is by an anaesthetist or an AA.^39,112

The safe management of unstable patients depends on close liaison between emergency physicians and anaesthetists,^33,34 to ensure that clear guidelines are in place, emergency department support staff are trained to assist with tracheal intubation, and audit and discussion of complications is undertaken regularly.

A local training module should be provided for anaesthetists in training according to their grade, supervised by a nominated educational lead. This programme should develop understanding of the widespread nature of cardiovascular disease, optimisation and risk stratification, as well as perioperative management. The RCoA revised training curriculum (2010) provides explicit detail of the requirements.⁴²

IPS should be staffed by multidisciplinary teams (MDTs) led by appropriately trained autonomously practising anaesthetists (see Glossary). The minimum training requirement for new appointments to IPS lead roles is stage 3 Special Interest Area Pain Medicine training.^1.3

Anaesthesia associates should work under the supervision of a consultant anaesthetist at all times as outlined by the RCoA.^97,93 In some emergency situations, a ratio of one to one and direct supervision may be more appropriate in view of the high incidence of comorbidities, complications and mortality.

Patients with morbid obesity who require emergency surgery should have experienced anaesthetists and surgeons available (typically, but not exclusively, at consultant level) to minimise operative time.¹⁷³ A surgical team familiar with emergency surgery in patients with morbid obesity and the complications associated with laparoscopic surgery should be available.