Anaesthetic assistants who cover obstetrics should demonstrate additional knowledge and skills specific to the care of pregnant women.32
Anaesthetists and anaesthetic assistants working without direct supervision in obstetric theatres and on the delivery suite should be familiar with the environment and working practices of that unit, and work there on a frequent basis to maintain that familiarity.
All theatre and post-anaesthetic recovery staff looking after the obstetric population should be familiar with the area for recovery of obstetric patients and be experienced in the use of the different early warning scoring systems for obstetric patients. They should have been trained to the same standard as for all recovery nurses, have maintained these skills through regular work on...
An adult resuscitation team trained in resuscitation of the pregnant patient should be immediately available.37
To act as duty anaesthetist without direct supervision from a consultant, the anaesthetist should meet the basic training specifications and have attained the RCoA’s Initial Assessment of Competency in Obstetric Anaesthesia.22
There should be a duty anaesthetist immediately available for the obstetric unit 24/7. This person’s focus is the provision of care to women in labour or who, in the antenatal or postpartum period, require medical or surgical attention. The role should not include undertaking elective work during the duty period.23
Objective assessment of risk should be routine. Identification of higher risk should trigger advanced planning specific to that case. Each hospital should have a system in place to identify high-risk surgical patients who require additional assessment. This should be based on:27
Busier units should consider having two duty anaesthetists available 24/7, in addition to the supervising consultant.24
In units offering a 24-hour neuraxial analgesia service, the duty anaesthetist should be resident on the hospital site where neuraxial analgesia is provided (not at a nearby hospital).
