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Information from the patient’s preoperative assessment should be readily available, ideally as part of an electronic patient record, so that information is easy to transfer between locations and to enable data collection for later analysis.^5,80

If the patient has not been seen in a preoperative clinic, (e.g. those admitted for urgent surgery), they should undergo an equivalent assessment and preparation process with the findings documented before their final anaesthetic assessment. Most patients for expedited urgent surgery should have the same assessment and preparation as for elective surgery.

Up to date, clear and complete information about operating lists should be available to the admissions area, theatre and recovery area. Operating lists should be made available to the anaesthetist before the list starts.

The language in all communications relating to the scheduling and listing of procedures should be unambiguous. Operating lists should include details of the patient’s operation, date of birth, hospital identification number, any alerts and the ward in which they are located. Laterality should always be written in full (i.e. ‘left’ or ‘right’).¹⁶⁸

The whole operating team should agree to any change to a published operating list. This list should be rewritten or reprinted, including a date and time of the update and should be clearly identifiable as a changed list.¹⁶⁸ Following a change in the theatre list, a further team brief should take place and the admissions area and recovery units...

Written guidelines should outline the policy for the collection of patients from the ward or admissions unit, as well as the handover by ward staff to a designated member of the operating department staff.¹⁶⁹

The theatre team should all engage in the use of the sequential steps from the National Safety Standards for Invasive Procedures commencing with a consent and procedural verification, and concluding the list with a team debrief or handover.¹⁶⁸ Debrief should highlight things done well and also identify areas requiring improvement.¹⁷⁰ Teams should consider including the declaration of emergency...

The anaesthetist should be with the patient at all times while the patient is anaesthetised. In hospitals employing AAs, this responsibility may be delegated to an AA, supervised by a consultant anaesthetist in accordance with the scope of practice for AAs.^119,123

In exceptional circumstances, an anaesthetist working singlehandedly may be called to briefly assist with or perform a lifesaving procedure nearby. This is a matter for individual judgement and a dedicated ODP or anaesthetic nurse should be present to monitor the patient in these exceptional circumstances.¹²³ This should be for as short a period as possible and the person left...

The following policies should be immediately and reliably available at sites where anaesthesia and sedation are provided:

• guidelines for the checking of anaesthetic machines¹²⁷
• guidelines for the management of anaesthetic emergencies, including anaphylaxis,^55,172,173malignant hyperpyrexia and major haemorrhage
• periarrest and cardiac arrest algorithms¹⁷⁴
• difficult airway management, including the ‘can’t ventilate, can’t oxygenate’ scenario.¹³³