Transport and distribution of blood and blood components at all stages of the transfusion chain must be under conditions that maintain the integrity of the product.9
Each unit should have a designated clinical lead (see glossary) for anaesthesia services for trauma and a designated lead for anaesthesia services for orthopaedic surgery. This should be recognised in their job plan and they should be involved in multidisciplinary service planning and governance within the unit.
Anaesthetists with a specific interest in orthopaedics and trauma should deliver regular theatre sessions to ensure the maintenance of their skills and experience.
All patients undergoing anaesthesia should be under the care of a consultant anaesthetist whose name is recorded as part of the anaesthetic record.2,3,4 A staff grade, associate specialist and specialty (SAS) grade anaesthetist could be the named anaesthetist on the anaesthetic record if local governance arrangements have agreed in advance that, based on the training...
Theatre staff should be available who are appropriately trained, skilled and experienced in the various surgical specialties that may present in the treatment of patients with multiple injuries.
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.
MTC and TU anaesthetic departments should consider appointing anaesthetists with an interest in prehospital care. Anaesthetists who provide prehospital care in the field should be qualified to do so.5
A range of operating tables with attachments for spinal, thoracic, pelvic and limb trauma procedures should be available.
Tourniquets and inflation devices of suitable sizes should be available for upper and lower limb surgery requiring a bloodless field.
