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Audit activity should include the regular analysis and multidisciplinary review of untoward incidents. Serious events and near misses must be thoroughly investigated and reported to the relevant national agency, in line with national requirements. Learning from serious events and near misses should be fed back to the MDT.⁸⁶

The obstetric anaesthetist should be informed and should be consulted when there is a multidisciplinary transfer of care of a pregnant or postpartum woman. This is particularly important when there is a physical transfer of care (e.g. transfer to or from a critical care ward or another hospital), which should necessitate direct communication between the obstetric anaesthetist and the other...

Hospitals must have guidelines in place to ensure the safety of children admitted to hospital, monitor injured children known to be at risk and identify concerns arising from any injury or pattern of injuries.^29,55They must provide the appropriate training related to these guidelines.

Arrangements to handover duties easily and swiftly should be made promptly and sympathetically to enable the anaesthetist or staff member to have time away from the workplace following a major adverse event. Additional support should be provided on return to work and also when the anaesthetist is presented with similar clinical scenarios.⁹⁷

A brief interruption of monitoring during transfer of the patient from theatre is only acceptable if the recovery area is immediately adjacent to the operating theatre. Otherwise, monitoring should be continued during transfer to the same degree as any other intra or inter-hospital transfer.^123,196

Patients requiring anaesthesia who are systemically unwell should be optimised as far as reasonably practicable beforehand.³⁵It is extremely rare for ophthalmic surgery to be so urgent that remedial measures cannot be taken. Arrangements for appropriate perioperative medical care should be made, with specialist input from other services as required.

There must be full provision of personal protective equipment and shielding from blood spray, radiation and hazardous substances for all staff working in the operating theatre. Guidance should be provided on its use.^108,110,111