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.

Every hospital should nominate an anaesthetic lead for obese patients undergoing surgery.⁴⁵

Medical records should include patients’ weight and body mass index.⁴⁵

The safe movement and positioning of obese patients may require additional staff and specialised equipment. An operating table, hoists, beds, positioning aids and transfer equipment appropriate for the care of obese patients should be available, and staff should be trained in its use.⁴⁵ Additional members of staff should be available where necessary, and manual handling should be minimised where possible.

The RCoA and Association of Anaesthetists currently do not support enhanced roles for AAs until the statutory regulation for AAs is in place. Where such role enhancement exists or is proposed, responsibility should be defined by local governance arrangements.¹¹²

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

The supervising consultant anaesthetist should be easily contactable and should be available to attend within minutes of being requested by the AAs.¹¹²

The supervising consultant anaesthetist should not be responsible for more than two anaesthetised patients simultaneously, where one involves supervision of an AA.¹¹²

Clinical governance of AAs should follow the same principles as that applied to medically qualified staff. This should include training that is appropriately focused and resourced, supervision and support in keeping with practitioners’ needs and practice responsibilities, and practice centred audit and review processes. AAs should always work within the remit and the educational curriculum of their training programme. 

There should be a dedicated trained assistant (i.e. an ODP, anaesthetic nurse or equivalent) who holds a valid registration with the appropriate regulatory body, immediately available in every location in which anaesthesia care is being delivered, whether this is by an anaesthetist or an AA.^39,112