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Monitoring equipment to detect air embolism and catheters for air aspiration should be available. The use of multiorifice catheters should also be considered.¹⁹

Those units conducting functional neurosurgery or surgery for correction of scoliosis, other relevant spinal surgery, or surgery for some cranial lesions, e.g. cerebellopontine angle tumours, should have the appropriate equipment and adequate numbers of trained staff for intraoperative neurophysiological testing. Neuroanaesthetists should be aware of the implications of this testing for anaesthesia including blood pressure management, use of neuromuscular blockade...

Equipment for safe positioning of patients with a wide range of body habitus should include:  

• appropriate sized mattresses
• positioning aids to minimise risk of eye injury, nerve injury as well as skin damage, e.g. pressure sores, during potentially prolonged operations
• fixings to prevent accidental movement during the procedure.

Equipment to monitor patient temperature and to provide targeted temperature management should be available.²¹

Availability of a cell salvage system should be considered for procedures associated with a risk of blood loss exceeding 25% of circulating volume.^22,23 Staff who operate this equipment should receive training in how to operate it and frequently use it to maintain their skills.

There should be same day availability of echocardiography investigations, including echo and ultrasound scanning.

Neuroradiology support should be available 24/7 for interpretation of neuroimaging.

In hospitals with dedicated neuroanaesthesia service there should be dedicated neurology input available.

Online imaging results from referring hospitals and within the neuroscience centre should be available locally, and consideration should be given to the provision of remote access for all anaesthetists who provide cover to neuroanaesthesia out of hours.

All anaesthetists, Anaesthesia Associates (AAs) and anaesthetic assistants, whether permanent or locum/agency staff, should undergo an appropriate induction process, which includes the contents of relevant policies and Standard Operating Procedures.^1,2 This should be documented.