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Clinicians undertaking emergency anaesthesia must be familiar with managing patients with a tracheostomy.^94,192

Anaesthetic personnel should be aware of the increased risk of awareness in emergencies, and take the necessary steps to minimise this risk, including monitoring the depth of anaesthesia, where indicated.^103,146

Utilisation of blood products should be minimised whenever possible by the employment of restrictive transfusion thresholds together with methods to minimise blood loss and allogenic transfusion.⁹⁰

Hospitals must have audited policies and procedures for the administration of blood and blood components that comply with standards set out by the National Blood Transfusion Committee.¹⁹³ Hospitals should have systems in place to ensure that blood can be cross matched, issued and supplied in a timely manner.

Hospitals should have a protocol for major haemorrhage in place and this should include clinical, laboratory and logistic responses.^90,98

Near patient coagulation testing should be considered in bleeding patients or centres where major bleeding is a regular occurrence.⁹⁰

Hospitals should have a policy covering the transfer of blood products with patients to and from other hospitals.¹⁹³

Experienced anaesthetic and surgical staff should manage obese patients. Ideally, morbidly obese patients should be preassessed by a senior anaesthetist.³⁵

Thromboprophylaxis protocols: all patients should undergo venous thromboembolism risk assessment and appropriate prophylaxis methods should be employed.^3,194 This should include guidance on the novel oral anticoagulants and the management of patients requiring emergency surgery who are receiving them.^195,196

Handover should be structured to ensure continuity of care.¹⁹⁹