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There should be a local guideline on the monitoring of women after regional anaesthesia and the management of post anaesthetic neurological complications.¹¹⁰

Written guidelines should cover the policy for the collection of patients from the ward or admissions unit, as well as the handover by ward staff to a designated member of the operating department staff.

Anaesthetic staff expected to care for patients with epidurals and continuous nerve blockade in situ should be trained to local guidelines before they top up medication or care for such patients.

Units where ophthalmic surgery is performed should be provided with guidelines, drugs and equipment to deal with complications and emergencies such as cardiac arrest, anaphylaxis and local anaesthesia toxicity.

Units should have local guidelines on the recognition and management of complications of regional analgesia that include training on the recognition of complications and access to appropriate imaging facilities when neurological injury is suspected. The patient’s general practitioner should be informed in the event of any of these complications.^15,136

Anaesthesia should be represented on all committees responsible for maternity services (e.g. the maternity services liaison committee, delivery suite forum, obstetric multidisciplinary guidelines committee, obstetric risk management committee).^22,25.59

There should be specific guidelines for assessing a suspected difficult airway, for example in patients with head and neck malignancy and in reconstructive burn surgery.⁶²