Search

Departments of neuroanaesthesia should be encouraged to develop research interests, even if not part of an academic department. Research collaboration with other neuroscience disciplines is good practice. Taking part in national anaesthesia and critical care projects is to be encouraged.^40,47

Audit programmes should be developed locally but should include continuous audit of transfer of brain injured patients, neurocritical care capacity and demand, rates of unplanned admission and readmission to the intensive care unit, and the caseload of trainees. In general, local practice should be audited against compliance rates with national and expert consensus guidelines.^7,40,48

Collaborative audit with the other neuroscience disciplines should be encouraged as well as close liaison and joint transfer audits with referring hospitals.⁶ 

Anaesthesia departments should make arrangements to allow anaesthetists working solo during long surgical procedures or on overrunning lists to be relieved by a colleague or AAs for meal and comfort breaks.^3,6

Regular morbidity and mortality meetings should be held jointly with neurosurgeons, interventional neuroradiologists and other relevant stakeholders.

Departments should be encouraged to maintain active links to national bodies and societies, e.g. NACCS Linkman Scheme, to facilitate national audit and dissemination of information.

Each department should provide written information specific to neurosurgical procedures, including relevant risks for surgery conducted in the prone position and postoperative visual loss (POVL).

All patients (and relatives where appropriate and relevant) should be fully informed about the planned procedure and be encouraged to be active participants in decisions about their care. Recommendations about the provision of information and consent processes outlined in chapter 2 should be followed.¹⁰

Although separate written consent for anaesthesia is not mandatory in the UK, there should be a written record of all discussions, including those of the requesting clinician, with patients undergoing sedation or anaesthesia for diagnostic procedures such as MRI scans. Discussion should include methods of induction, associated risks, side effects and potential benefits of the procedure. It is not the...

The scope of the authority that has been given by a patient should not be exceeded except in an emergency. In an emergency clinical situation in which it is not possible to find out a patient’s wishes, a patient should be treated without their consent, provided the treatment is immediately necessary to save their life or to prevent a serious...