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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.

Staff assigned to the role of anaesthetic assistant should not have any other duties that would prevent them from providing dedicated assistance to the anaesthetist during anaesthesia.³⁹

Children should always be managed in accordance with RCoA and Association of Paediatric Anaesthetists of Great Britain and Ireland recommendations.^26,27

Guidelines including those published by the Association of Paediatric Anaesthetists of Great Britain and Ireland for the management of children referred for dental extractions under general anaesthesia should be followed.⁵⁵

Head and neck anaesthetists should actively engage and contribute to regional and national head and neck outcome databases and audit.^5,51

As part of a difficult airway follow-up, patients should be informed in writing about any significant airway problem encountered, and be advised to bring it to the attention of anaesthetists during any future preoperative assessment.

Information about anaesthesia during vascular surgery such as the Royal College of Anaesthetist’s ‘Your anaesthetic for vascular surgery’ leaflet should be available.⁴⁷

In units designated as complex arterial centres, additional programmed time should be allocated to vascular anaesthetists delivering this service to allow them to engage with the multidisciplinary team (MDT) and provide support to allied specialties.

Departments should ensure that vascular anaesthetists and support staff are available to provide a year round service. This should include prospective cover for sickness and planned leave.⁴