Search

Immediate postoperative management involves multidisciplinary care but overall responsibility is the named consultant anaesthetists.

Wherever thoracic anaesthesia and surgery are performed there should be a resident anaesthetist available at all times.

The anaesthetist should be part of a burns multidisciplinary team.⁴

Anaesthesia for the emergency control of major traumatic haemorrhage, and other damage limiting interventions in the operating theatre or radiology intervention suite, should be consultant anaesthetist led. Where consultants are not resident, clear lines of communication and notification should be in place to allow early attendance to trauma calls.

The definitive care of complex spinal and pelvic injuries requires early multidisciplinary specialist spinal (orthopaedic or neurosurgical surgery) and pelvic team discussion. The anaesthetist managing such cases should have appropriate training and experience in management of these complex patients including management of associated complications.

All institutions where sedation is practised should have a sedation committee. This committee should include key clinical teams using procedural sedation and there should be a nominated clinical lead for sedation. In most institutions, the sedation committee should include an anaesthetist, at least in an advisory capacity.

Any autonomously practising anaesthetist working in neuroanaesthesia must undertake continuing professional development (CPD) in neuroanaesthesia and must have sufficient regular programmed activities within this field to ensure that their specific skills and experience are maintained.²⁷

There should be a minimum of one member of the recovery staff, or an anaesthetist with advanced training in paediatric life support on duty. All members of recovery staff should have up-to-date paediatric competencies including resuscitation.²⁰¹

Many procedures do not have to be performed out of hours.³⁵Anaesthetists and surgeons together should devise departmental protocols for the handling of patients requiring urgent procedures, to allow prioritisation from both surgical and anaesthetic perspectives.