A small number of centres perform burn surgery. These centres should offer external training opportunities for anaesthetists, nursing staff, physiotherapists and other members of the multidisciplinary team.48
Any scheduled burn lists should be organised and staffed by appropriately trained anaesthetists and surgeons, working regularly in that area, who have no conflicting clinical commitments.50
Any scheduled plastic surgery trauma lists should be organised and staffed by senior anaesthetists and surgeons, working regularly in that area and without conflicting clinical commitments.50
Each unit should have a designated clinical lead (see glossary) anaesthetist for thoracic anaesthetic services. This should be recognised in their job plan and they should be involved in multidisciplinary service planning and governance within the unit.
Continuity of care should be a priority in prolonged cases and when this is not possible, a formal documented process with some overlap should be in place for handover of clinical care from one anaesthetist to another.3
All anaesthetic equipment should be checked before use in accordance with the Association of Anaesthetists published guidelines. Anaesthetic machine checks should be recorded in a log and on the anaesthetic chart.36
Cardiothoracic anaesthetists working in non-transplant centres should be familiar with the principles of the anaesthetic management of patients who have previously undergone heart or lung transplantation.49
Delivery suite rooms should have oxygen, suction equipment and access to resuscitation equipment. Equipment should be checked daily in accordance with the Association of Anaesthetists published guidelines.38
Hospitals should have approved documentation defining safe staffing levels for anaesthetists and anaesthetic assistants, including contingency arrangements for managing staffing shortfalls, and annual reviews of compliance with these should be performed.
Provision of supernumerary training sessions for non-specialist anaesthetists expected to provide out-of-hours or emergency care on the maternity unit should be the subject of review.132
