Search

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.

All anaesthetists involved in the management of major trauma should understand the principles and techniques of damage control resuscitation to prevent lethal triad of hypothermia, acidosis and coagulopathy using low volume fluid resuscitation, blood products and damage control surgery.⁷

AAs should always work within an anaesthesia team led by a consultant anaesthetist who has overall responsibility for the anaesthesia care provided for the patient and whose name should be recorded in the individual patient’s medical notes.¹¹²

All anaesthetists with a job plan including sessions in non-theatre anaesthesia should be able to demonstrate continued competency through maintenance of an appropriate level of experience, and ongoing participation in relevant continuing professional development.^1,57

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.

There should be an appropriately trained theatre team including an on-call consultant or other autonomously practicing anaesthetist 24/7 to provide anaesthesia for emergency head and neck surgery in head and neck cancer centres and in hospitals with an emergency department (ED).⁹

Many head and neck cancer patients have significant comorbidities that may require optimisation prior to surgery. There should be a lead anaesthetist for preoperative assessment who works closely with an appropriate preoperative assessment team.¹²

Patients requiring head and neck procedures should be managed by anaesthetists who have had an appropriate level of training in this field and who have acquired the relevant knowledge and skills needed to care for these patients.^41,42

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.