Search

Perioperative time should be allocated for the work the anaesthetist undertakes on the day of surgery for both preoperative and postoperative care. The times allocated might vary per patient but for most theatre lists, it approximates to one hour per four hours spent in the operating theatre suite or two hours per eight hours in the operating theatre suite.

Bariatric patients requiring emergency surgery should have experienced surgeons and anaesthetists available (typically, but not exclusively, at a consultant level), in order to minimise operative time.^85,127

A multidisciplinary team approach is highly recommended, typically involving anaesthetists, obstetricians, surgeons, paediatricians and midwives.^{137,138,139,140}

Preoperative assessment, optimisation, manipulation of patients’ normal drugs and shared decision-making in patients with diabetes requires a cross specialty approach involving anaesthetists, surgeons, diabetologists and diabetes inpatient specialist nurses. The development of such teams requires time and resources. This should be recognised and provided.³⁸

In units where trainee anaesthetists work a full or partial shift system, and/or rotate through the department every three months (or more frequently), provision of additional consultant programmed activities should be considered, to allow training and supervision into the evening.²⁹

There should be a duty anaesthetist immediately available for the obstetric unit 24/7. This person’s focus is the provision of care to women in labour or who, in the antenatal or postpartum period, require medical or surgical attention. The role should not include undertaking elective work during the duty period.²³

Members of clinical staff working within the recovery area should be certified to a standard equivalent to intermediate life support providers, and training should be provided.⁴⁴ An advanced life support provider or an anaesthetist should be available at all times.