All pregnant women requiring caesarean birth should, except in an extreme emergency, be visited and assessed by an anaesthetist before arrival in the operating theatre. This should allow sufficient time to weigh up the information to give informed consent for anaesthesia.137
Guidelines (e.g. those published by the Association of Paediatric Anaesthetists of Great Britain and Ireland) should be followed for the management of children referred for dental extractions under general anaesthesia.35 Further information on anaesthesia for community dentistry is available in chapter 7.
Vascular anaesthetists should have the appropriate skills and knowledge regarding invasive cardiovascular monitoring, cardioactive or vasoactive drugs, strategies for perioperative organ protection (renal, myocardial and cerebral), the management of major haemorrhage, and the maintenance of normothermia.29
Anaesthetists should always be supported by dedicated, appropriately skilled and trained assistants. Recovery facilities should be staffed during all operating hours and should have appropriate anaesthesia support until the patient meets agreed discharge criteria.12
Anaesthetists who prescribe oral sedation for paediatric burn patients do not need to be physically present for the procedure for which sedation is being prescribed but they, or other suitably trained and experienced staff, need to be available to return immediately if the need arises.53
If a patient is transferred to the recovery unit with a tracheal tube in situ, the anaesthetist remains responsible for the removal of the tube but may delegate its removal. Delegation should be to an appropriately trained member of staff who is prepared to accept this delegated responsibility.178
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.199
