Cardiothoracic anaesthetists working in non-transplant centres should be familiar with the principles of the anaesthetic management of patients who have previously undergone heart or lung transplantation.49
There should be a named consultant anaesthetist responsible for every elective caesarean delivery operating list. This consultant should be immediately available. The named consultant should have no other clinical responsibilities.
The anaesthetist should have a competent trained assistant immediately available for the duration of any anaesthetic intervention and this practitioner should not have any other duties.31
Delivery suite rooms should have oxygen, suction equipment and access to resuscitation equipment. Equipment should be checked daily in accordance with the Association of Anaesthetists published guidelines.38
Hospitals should have approved documentation defining safe staffing levels for anaesthetists and anaesthetic assistants, including contingency arrangements for managing staffing shortfalls, and annual reviews of compliance with these should be performed.
Provision of supernumerary training sessions for non-specialist anaesthetists expected to provide out-of-hours or emergency care on the maternity unit should be the subject of review.132
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.
Healthcare workers, including the anaesthetist, must be aware of the local policy for child protection, and that they have an obligation to document and report any concerns to a responsible individual.41
The definitive care of complex spinal and pelvic injuries requires specialist spinal (orthopaedic or neurosurgical) and pelvic surgery. The anaesthetist managing such cases should have appropriate training and experience in the management of these cases and their associated complications.
Anaesthetists who manage patients with major trauma should consider undertaking advanced trauma life support (ATLS), European Trauma Course (ETC) or equivalent training, and should update their training at regular intervals.
