Experienced anaesthetic and surgical staff should manage obese patients. Ideally, morbidly obese patients should be preassessed by a senior anaesthetist.35
All major head and neck surgery should be overseen by a named consultant or autonomously practising anaesthetist with a subspecialty interest in this area.77
The lead obstetric anaesthetist should ensure that there are ongoing quality improvement projects in place to maintain and improve the care in their units.27
Anaesthetists and anaesthetic assistants working without direct supervision in obstetric theatres and on the delivery suite should be familiar with the environment and working practices of that unit, and work there on a frequent basis to maintain that familiarity.
In units offering a 24-hour neuraxial analgesia service, the duty anaesthetist should be resident on the hospital site where neuraxial analgesia is provided (not at a nearby hospital).
Only individuals who appear on the voluntary register currently administered by the Royal College of Anaesthetists should be employed in the AAs role.14
The supervising consultant anaesthetist should not be responsible for more than two anaesthetised patients simultaneously, where one involves supervision of a AAs.3
Consultant anaesthetists and intensivists should be involved in the planning of local trauma services. Those with defined responsibility for major trauma management should be engaged in the layout and logistics of the resuscitation room.
Trained staff and appropriate facilities should be immediately available for emergency resternotomy and bypass. A suitably trained resident anaesthetist should be immediately available for emergencies.5
An appropriately trained consultant anaesthetist should be available at all times, through a formal thoracic or cardiothoracic anaesthetic on-call rota, particularly if lung transplantation is performed.
