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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

The following policies should be held and easily accessible for:

• WHO checklist, including time out⁴
• ‘Stop Before You Block’¹⁷⁵
• ‘Do not attempt cardiopulmonary resuscitation’
• death in the operating theatre²¹
• major incident
• infection control (including antibiotic prophylaxis, staff protection and post exposure prophylaxis)¹⁴⁸
• prevention of hypothermia¹³⁴
• major haemorrhage¹⁷⁶
• blood and blood products administration^177...

Patient care should be transferred to staff who have been specially trained in recovery procedures and reached locally or nationally agreed prescribed competencies, such as the UK National Core Competencies for Post-Anaesthesia Care 2013.^41,180,181

On occasions, patients may be handed over to the recovery practitioner with a supraglottic airway device in place. The person taking over direct clinical care of such a patient should be specifically trained in the management and safe removal of the airway device.¹³¹

If a patient is transferred to the recovery unit with a tracheal tube in situ, the anaesthetist remains responsible for the removal of the tube but may delegate its removal. Delegation should be to an appropriately trained member of staff who is prepared to accept this delegated responsibility.¹⁸⁰

An anaesthetist should have overall responsibility for the transport of patients from theatre to the recovery unit.¹⁸²

Anaesthetists or a delegated AA should formally handover the patient, and should remain in the recovery unit if their input is required. They should leave the patient in a stable condition.^131,183,184

The patients anaesthetist should retain overall responsibility for the patient during the recovery period and should be readily available for consultation until the patient is able to maintain their own airway, has regained respiratory and cardiovascular stability and is able to communicate, unless this care has been handed over to another named anaesthetist. Where the patient’s anaesthetist is not the...