Dedicated second-stage recovery (which is usually the day surgery ward) should be provided separately from inpatient ward areas. Ideally, this area should have a single-sex set-up with respect for gender identity.38
The decision on the most appropriate place for the treatment of a teenager or young person should be made on an individual basis, balancing the expertise of the clinician in the patient’s condition against any effort to fully separate adult patients from teenagers. Local operating policies should be in place to support this decision.
Units should have access to ultra-short-acting opioids with stable context-sensitive half times deliverable by infusion using software accommodating a range of appropriate pharmacokinetic models that permits intraoperative cardiostability, smooth emergence from anaesthesia and rapid and accurate postoperative neurological assessment.
If responsibility for care is transferred from one anaesthetist to another, a ‘handover protocol’ should be followed, during which all relevant information concerning the patient’s medical history, medical condition, anaesthetic status, and plan should be communicated.182
Mechanisms for the early recognition of patients requiring specialist postoperative input from geriatrician led services and/or critical care should be developed. These should include patients at risk of or presenting with delirium, multiple medical complications, functional decline or those requiring complex discharge planning.
