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Departments that participate in national initiatives, e.g. services for thrombectomy, should review their staffing arrangements to ensure timely emergency cover. Planning for such services should include increased anaesthetic service requirements.
There should be a system in place for antenatal anaesthetic review of obese women with a body mass index (BMI) >40 kg/m2,74 Assessment should be arranged to ensure timely delivery planning can take place.75
The duty anaesthetist should be informed as soon as a woman with a BMI above a locally agreed threshold is admitted.
There should be appropriate equipment to care for obese women.76
There should be a multidisciplinary protocol governing care of these patients that includes: consent, the environment in which these patients are cared for, and the staff responsible for caring for these young people.
High-risk patients should be discussed in regular specialty multidisciplinary team (MDT) meetings with anaesthetic representation. Such an arrangement facilitates robust team decision-making with regard to patient care while minimising delays in the surgical pathway. Clinical time should be agreed in job plans to reflect this commitment. There should be an anaesthetic MDT led by anaesthetists and including cardiologists, respiratory physicians...
Anaesthetists should be aware of legislation and good practice guidance77,78,79 relevant to children and according to the location in the UK.80,81,82,83 These documents refer to the rights of the child, child protection processes and consent.
Anaesthetists must undertake at least level 2 training in safeguarding/child protection,84 and must maintain this level of competence by regular annual updates on current policy and practice and case discussion.85
At least one anaesthetist in each anaesthetic department, not necessarily an obstetric anaesthetist, should take the lead in safeguarding/child protection86 and undertake training and maintain core level 3 competencies. The lead anaesthetist for safeguarding/child protection should liaise with their multidisciplinary counterparts within the obstetric unit.
Anaesthetic machines, monitoring and infusion equipment and near patient testing devices should be maintained, repaired and calibrated by medical physics technicians.
