Where possible, day surgery is preferable to avoid disrupting normal routines. Guidelines from the Association of Anaesthetists Guidelines on breastfeeding and sedation in breastfeeding women should be followed.56
The anaesthetist plays a key role in the multidisciplinary team who apart from being involved in airway management in major trauma patients, should provide input into the recognition and management of acute physiological derangement, haemorrhage, and shock.
Anaesthetists providing anaesthesia for trauma and orthopaedic surgery should learn and maintain expertise in a wide range of regional anaesthetic techniques, including central and peripheral neural blockade.96
Anaesthetists who do not have regular children’s lists but who do have both daytime and out of hours responsibility for providing care for children requiring emergency surgery should maintain appropriate clinical knowledge and skills.
The anaesthetist accompanying transferred patients to the radiology department should be suitably skilled and experienced to manage all eventualities in an isolated environment and should be accompanied by a dedicated trained assistant.7
Adequate recovery room facilities that comply with the Association of Anaesthetists’ recommendations for standards of monitoring during anaesthesia and recovery should be available within the delivery suite theatre complex.43
Any non trainee anaesthetist who undertakes anaesthetic duties in the labour ward should have been assessed as competent to perform these duties in accordance with RCoA guidelines.20
To maintain the necessary repertoire of skills, anaesthetists providing a burn and plastic surgery anaesthesia service should have a regular commitment to the specialty, and adequate time must be made for them to participate in a range of relevant CPD activities.
Each unit should have a designated clinical lead (see Glossary) anaesthetist who is responsible for cardiac anaesthesia services. This should be recognised in their job plan and they should be involved in multidisciplinary service planning and governance within the unit.
