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Introduction 

There are increasing numbers of diagnostic and therapeutic procedures performed outside the main theatre environment, in both elective and emergency situations. These procedures may require anaesthetic involvement through haemodynamic monitoring during the procedure, sedation, regional anaesthesia or general anaesthesia. The challenge for anaesthesia is to develop a framework that supports and regulates the safe delivery of care.

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Introduction

Pregnancy and childbirth remains a risky time for both mother and baby. In recent years, we have seen the maternal mortality rate plateau.^7,8,9 

However, the confidential review of every maternal death over the past seven decades continues to identify that substandard care, frequently caused by deficiencies in service provision, has led to avoidable...

Introduction

Infants, children, and young people have different requirements. There are marked developmental changes within the paediatric age range, and neonates, infants, and prepubertal children under the age of 8–12 years have particular anatomical and physiological differences. Doses of drugs and fluids need to be precisely calculated, and anaesthetic equipment for smaller children differs from that used in older children...

Introduction

Regional anaesthesia (RA) is an important component of anaesthetic practice. It includes neuraxial and peripheral nerve block techniques which may be used for either perioperative anaesthesia or analgesia, as well as other non-surgical indications such as chronic pain and traumatic rib fractures. The practice of RA has changed significantly, particularly over the past three decades.¹ The introduction of...

Introduction 

Head and neck surgery includes a wide spectrum of surgical interventions, ranging from short daycase procedures to long and complex operations.¹ The requirements for providing anaesthesia services for routine head and neck surgery, such as tonsillectomy, will be different to those required to provide anaesthesia for major or complex surgery. There should be recognition that routine head and...

Introduction

Trauma remains the most common cause of loss of life in the under 40s age group in the UK, and as such major trauma centres (MTCs) and trauma units (TUs) have been established to receive patients of all ages and to improve outcomes.¹ Early anaesthetic involvement is beneficial at all stages, from the prehospital setting, to emergency departments...

Introduction

The range of procedures requiring anaesthesia for burn and plastic surgery is wide and includes patients of all ages. Procedures range from common minor injuries (dog bites, nail bed injuries) to planned congenital cleft lip and palate and hand procedures, and less frequently major burns and free-flap surgeries requiring multidisciplinary perioperative critical care. The recommendations in this chapter should...

Introduction 

From their inception, IPS have provided acute post-surgical pain management to promote a balance of symptomatic relief and early restoration of function to improve patient experience and surgical outcomes. An ongoing and important role of the IPS is the consistent training and education of staff and students across the wider hospital trust. Other responsibilities continue to expand into...

Introduction

It is nearly two decades since it was widely reported that the outcome from abdominal aortic aneurysm (AAA) surgery was significantly worse in the UK than in comparable countries.¹ The 2005 NCEPOD report Abdominal Aortic Aneurysm: A service in need of surgery² subsequently led to a national Abdominal Aortic Aneurysm Quality Improvement Programme (AAAQIP) being introduced...

Introduction

Neuroanaesthesia encompasses a wide range of emergency and elective work. Anaesthesia for intracranial oncology, vascular, hydrocephalus, trauma/neurotrauma, functional surgery, complex spinal surgery, as well as anaesthesia for diagnostic and interventional neuroradiological procedures, including MRI, all lie within the specialty.

Neuroanaesthesia is mainly delivered in neuroscience units, which may be based in specialist centres, teaching hospitals or district general hospitals...