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An anaesthetic office, located within five minutes’ walk of the delivery suite, should be available to the duty anaesthetic team. The room should have a computer with intra/internet access to specialist reference material and local multidisciplinary evidence based guidelines and policies. The office space, facilities and furniture should comply with the Association of Anaesthetists' standards.⁸⁰ This office could...

When it is considered appropriate for a do not to attempt resuscitation in the event of a cardiopulmonary arrest (DNACPR) order, it should be discussed with capacitous patients, including those who have expressed their own wish not to be resuscitated.^106,107 In patients not capacitous to consent, every attempt should be made to discuss this with next of...

Risk stratification based on clinical history may help guide management.³⁶ However, determination of a patient’s functional capacity may be difficult if exercise tolerance is limited by peripheral vascular insufficiency, respiratory or other disease.^10,35 Clinical guidelines should be developed for further investigation, referral, optimisation, and management according to local facilities and expertise.³⁷

The lead obstetric anaesthetist should be responsible for the overall delivery of the service, including:

• ensuring that evidence based guidelines and protocols are in use and are up to date
• monitoring staff training
• workforce planning
• service risk management
• ensuring that national specifications are met
• auditing the service against agreed standards, including anaesthetic complication rates, as set out in the RCoA ...