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Units should have local guidelines on the recognition and management of complications of neuraxial analgesia that include training on the recognition of complications and access to appropriate imaging facilities when neurological injury is suspected.

Intravenous fluid management should conform to NICE guidelines, and appropriate equipment to deliver this safely and accurately should be available.¹⁸

Hospitals should regularly review local standards and policies related to regional anaesthesia and ensure they are harmonised with national safety standards and guidelines.¹⁸

Association of Anaesthetists Consensus guidelines on regional anaesthesia for patients at risk of lower limb compartment syndrome should be followed. Discussion of risk with the patient should occur where possible.

Guidelines for the management of pregnant women receiving anticoagulation, and for the recognition and management of complications of regional analgesia/anaesthesia should be available, including access to appropriate imaging facilities if neurological injury occurs.

A standardised ‘difficult airway trolley’ should be immediately available in all areas where major trauma patients are received or managed to level 2 (or greater) standards of care. These should be equipped as defined in the Difficult Airway Society (DAS) guidelines.^5,77,78

Local and national guidelines should be adhered to for patients requiring inter-hospital transfer to the regional trauma centre.⁵⁵ Equipment for transfer should be organised in accordance with the recommendations of the collaborative framework of the Royal College of Emergency Medicine and the Faculty of Intensive Care Medicine.⁵⁴

Monitoring during cardiopulmonary bypass should conform to the standards recommended by the joint working group of the Society of Clinical Perfusion Scientists of Great Britain and Ireland, ACTACC, the Society for Cardiothoracic Surgery in Great Britain and Ireland, and the European Guidelines on Cardiopulmonary Bypass in Adult Cardiac Surgery.^7,18