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Anaesthetists should be aware of the risks of exposure to ionizing radiation in cardiac catheterisation laboratories and ensure they use protective garments and screens and wear exposure monitoring devices if requested to do so.⁵⁶

The use of dedicated anaesthetic monitoring equipment, in addition to any monitoring used by cardiologists, is recommended. A remote or slave anaesthetic monitor display should be available to cardiologists.

Cardiac patients are often at high risk of cardiac arrest. Sufficient space and facilities should be available for managing this eventuality.

Cardiovascular instability may, on occasion, necessitate the use of extracorporeal support. Catheter laboratories should have sufficient space, medical gas outlets, electrical sockets, network sockets, and other essential facilities to meet this demand.

Where revision of rhythm management devices is considered to be pose high risk of requiring emergency surgical intervention, cardiopulmonary bypass equipment and a plan for surgery should be available at the start of the procedure.

Some patients may require additional monitoring equipment. The following should be considered:⁴

• invasive pressure monitoring
• cardiac output monitors
• depth of anaesthesia monitoring.³⁵

In recent years there has been a trend towards assessment of elective patients in preadmission clinics, typically one to two weeks before surgery. This allows routine paperwork and investigations to be completed before admission, permits ‘same day’ admission and reduces the likelihood of delays or cancellation.⁵⁷ Anaesthetists should be part of the preadmission clinical pathway, including implementing interventions to...

Cardiac and thoracic anaesthesia is a ‘key unit of training’ for intermediate level training in anaesthesia.⁶¹ Trainee anaesthetists should be of appropriate seniority to be able to benefit from this area of training.

All trainees should be appropriately clinically supervised at all times.⁶²