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In units where ophthalmic surgery is performed, including locations that may be isolated from main theatre services, facilities provided should allow for the safe conduct of anaesthesia and sedation. This would include monitoring equipment, oxygen, availability of opioid and benzodiazepine antagonist drugs, a recovery area, and drugs and equipment to deal with emergencies such as cardiac arrest, anaphylaxis and local...

All areas in which ophthalmic anaesthesia is performed should have a reliable supply of the medicines required to deliver safe anaesthesia and sedation. Storage arrangements should be such that there is prompt access to them if clinically required, maintains integrity of the medicines and compliance with safe and secure storage of medicines regulations is ensured.³⁰ In addition, anaesthetists and...

Facilities should be available, or transfer arrangements should be in place, to allow for the overnight stay of patients who cannot be treated as day cases or who require unanticipated admission.

Optimal patient positioning is critical to the safe conduct of ophthalmic surgery and for patient comfort. Adjustable trolleys/operating tables which permit correct positioning should be available.

Some patients, for example those with restricted mobility, may require specific equipment such as hoists to position them. Preoperative planning should ensure that such equipment is available, and allow for the extra time and staff needed to position these patients safely.

In areas where ophthalmic surgery is performed, resuscitation equipment and drugs should be immediately available in case of cardiorespiratory arrest. These should include a standardised resuscitation trolley and defibrillator. The manufacturer’s instructions must be followed regarding use, storage, servicing and expiry of equipment and drugs.⁸

Where risks of adverse patient outcome with surgery are identified as being high, the preoperative assessment consultation facilitates shared patient discussion, which may result in a well-informed individual opting for non-surgical management. Under such circumstances the decision-making process should be endorsed through close collaborative discussion with surgical colleagues - ideally a preoperative MDT meeting.

Where paediatric ophthalmic surgery is performed, appropriate paediatric anaesthetic equipment and monitoring should be available. This should be checked regularly.¹⁵

Adult life support (ALS) protocols should be readily accessible,¹⁶ and the ALS algorithms may be displayed. Paediatric life support protocols should be available and accessible where paediatric surgery is performed.

Monitoring devices should be available for the safe conduct of anaesthesia. The minimum monitoring requirements should be adhered to for local and general anaesthesia.^2,17