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Introduction

Day surgery is the planned admission of a surgical patient for a procedure where the patient is admitted, undergoes surgery and is discharged on the same calendar day.¹ If the patient remains in a hospital bed overnight on the day of their surgery they are classed as having undergone inpatient surgery. The term ‘23-hour stay’ surgery is short-stay...

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

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 

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.

Commercial and...

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

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

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...

Introduction

Cardiac anaesthesia services are provided for patients undergoing cardiac procedures. To reflect current practice, these guidelines have been more clearly divided to identify areas of differing requirement. Anaesthetists in cardiac surgical services are now more frequently required to provide anaesthesia for invasive cardiology procedures in the catheter laboratory. Intraoperative transoesophageal echocardiography is a specialist skill that cardiac anaesthetists are...

Introduction

Thoracic anaesthesia services are provided for patients undergoing thoracic procedures. To reflect current practice, these guidelines have been more clearly divided to identify areas of differing requirement.

Thoracic surgery may include surgery on the lungs (including lung transplantation), pleura, thymus, oesophagus and other thoracic structures, as well as the chest wall. Less invasive video assisted surgery is now mainstream...

Introduction

The Guidelines for the Provision of Anaesthetic Services (GPAS) supports the development and delivery of high quality anaesthetic services. The ACSA scheme supports departments of anaesthesia to implement the recommendations contained within GPAS. This is achieved through a set of standards, derived from GPAS, against which a department is able to benchmark itself through self-assessment and peer review.

GPAS...