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An appropriately trained and experienced anaesthetist with regular commitments to burn and plastic surgery should be present during the conduct of general and regional anaesthesia for operative procedures, including those procedures requiring intravenous sedation where it has been agreed that this will be provided by the anaesthesia department.

An anaesthetist should be physically present when a general anaesthetic is administered. In exceptional circumstances, anaesthetists working singlehandedly may be called on briefly to assist with or perform a lifesaving procedure nearby. This is a matter for individual judgement, and a dedicated anaesthesia assistant should be present to monitor the unattended patient.¹¹

A clinical lead for burn and plastic surgery anaesthesia should be appointed in each hospital providing anaesthesia for this specialty. The clinical lead (see Glossary) anaesthetist in burn and plastic surgery units will be responsible for the provision of service, teaching, production of guidelines, management, research and audit, and should be able to support quality improvement initiatives. Sufficient time...

Anaesthetists should always be supported by dedicated, appropriately skilled and trained assistants. Recovery facilities should be staffed during all operating hours and should have appropriate anaesthesia support until the patient meets agreed discharge criteria.¹²

There should be adequate numbers of competent medical and non-medical staff to provide 24/7 cover for emergency burn and plastics anaesthesia.¹³

Where a paediatric service is being provided, all medical and non-medical staff, including recovery room staff, should have relevant and recent training in paediatric anaesthesia and resuscitation.^4,14,15

There should be specific consultant or autonomously practising anaesthetist programmed activity time for burn anaesthesia in hospitals where burn surgery is undertaken.⁴