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Anaesthetic staff expected to care for patients with epidurals and continuous nerve blockade in situ should be trained to local guidelines before they top up medication or care for such patients.

Anaesthetic practitioners involved in the administration of anticoagulant therapies should have current and up to date knowledge in their use.

Services should be available for:

• blood transfusion
• radiology
• haematology
• clinical pathology
• electrocardiography.

There should be regular multidisciplinary in situ simulation training for the initial management of major trauma care and resuscitation to standardise clinical practice.  Simulation can improve technical and non-technical skills including communication and teamwork. ⁵⁸

Awareness of regional analgesia benefits in chest trauma and early referral to acute pain services should be emphasised within the multidisciplinary trauma team.⁵⁹

The diagnostic and therapeutic applications of POCUS in trauma are expanding. There is a need for emphasis on quality training of POCUS operators within the trauma multidisciplinary team.^{60, 27}

Major incident training exercises should take place at regular intervals.

Patients with obstructive sleep apnoea have a higher incidence of postoperative complications including hypoxia, renal failure, unplanned intensive care unit (ICU) stay, and delayed discharge. Therefore, consideration should be given to monitoring such patients in an high dependency unit (HDU) environment postoperatively.⁴⁴

Patient care should be transferred to staff who have been specially trained in recovery procedures and reached locally or nationally agreed prescribed competencies,³ such as the UK National Core Competencies for Post-Anaesthesia Care 2013.⁴

On many occasions, patients will be handed over to the recovery practitioner with a laryngeal mask airway or other supraglottic airway device in place. The person taking over direct clinical care should be specifically trained in the management of these patients and in the safe removal of the airway device.⁵