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Children should be separated from and not managed directly alongside adults throughout the patient pathway, including in waiting rooms, preassessment clinic rooms and theatre areas, including anaesthetic and recovery areas, as far as possible.215 These areas should be child-friendly and should be staffed by suitably trained and qualified practitioners within recovery.201
Children undergoing surgery should be grouped into paediatric lists, or together at the start of mixed lists.213,214
Preoperative fasting should be minimised as much as possible, especially for infants and younger children.216
All clinical staff working with children should have up to date certification in safeguarding level 2.203
There should be a policy in place for pregnancy testing for young female patients under the age of 16 years. This policy should adhere to Royal College of Paediatrics and Child Health guidance.218
Information on the risks and the common adverse effects of anaesthesia in children, and the long-term effects of anaesthesia, should be discussed and offered in writing to children, parents and guardians.209,219
Where designated separate areas for children are not available, discrete segregated areas in the pre and postoperative pathways should be available. They should be made as child friendly as possible.117
Children should never be left unattended in the recovery area.220
Children have an increased incidence of postoperative delirium. Recovery staff should have an increased awareness and there should be local protocols for the management of this condition.209
Children with learning disabilities should ideally be recovered in an area with lower levels of noise and lighting and a familiar presence, such as a parent or their carer.209