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A local policy on analgesia for home use should be in place, with either provision of medications, or advice to parents and carers before admission to purchase suitable simple analgesics. In both instances, there should be clear instructions to parents and carers about their regular use in the correct dose and for a suitable duration. Parents and carers should be...
Neonates, infants and children who are likely to require critical care following an operation should undergo their surgery in a hospital/unit with a designated PICU or NICU.39,41
If the patient is too sick to transfer to such a hospital prior to surgery and their current hospital has surgeons capable of operating, then transfer should occur as soon after surgery as is clinically appropriate.13
The decision on the most appropriate place for the treatment of a teenager or young person should be made on an individual basis, balancing the expertise of the clinician in the patient’s condition against any effort to fully separate adult patients from teenagers. Local operating policies should be in place to support this decision.
Where treatment is carried out in facilities normally used by adult patients, such as obstetric units or for patients requiring ECT treatment, guidelines should be in place for staff training and organisation of services.45,46
There should be provision for carbohydrate drinks to take preoperatively where appropriate.44
Where children are transferring from paediatric to adult services there should be the opportunity to advise them about possible changes in anaesthesia management. Examples may include the use of sedation for some procedures that previously would have been managed with general anaesthesia, or the use of alternatives to topical anaesthesia.33
A person centred approach should be used to ensure that the young person is an equal partner in decisions regarding their care during this transitional period.33
Anaesthesia records from their previous care should be available to the new service (or a summary document should be provided).33
Health and social care service managers in children's and adults' services should work together in an integrated way to ensure a smooth and gradual transition for young people.47
