In units designated as complex arterial centres, additional programmed time should be allocated to vascular anaesthetists delivering this service to allow them to engage with the multidisciplinary team (MDT) and provide support to allied specialties.
Departments should ensure that vascular anaesthetists and support staff are available to provide a year round service. This should include prospective cover for sickness and planned leave.4
All anaesthetists involved in the management of major trauma should understand the principles and techniques of haemorrhage control resuscitation to prevent the lethal diamond of hypothermia, acidosis, coagulopathy and hypocalcemia using low-volume fluid resuscitation, blood products and damage control surgery.94,98,99
Children currently transition to adult congenital heart disease services at the age of 16–18 years, although transition services are integrated into the care pathway from 12 years of age. Anaesthetists should be aware of legislation and good practice guidance relevant to young and vulnerable adults.35,41
Clinical governance is the responsibility of individual institutions and, for AAs, this should follow the same principles that apply to medically qualified anaesthetists, ensuring:15
To maintain the necessary knowledge and skills, vascular anaesthetists should have a regular commitment to the specialty. Adequate time must be made for them to participate in relevant MDT meetings and continuing professional development (CPD) activities. This should include the facility and resources to visit other centres of excellence to exchange ideas and develop new skills where appropriate.28
Patients receiving emergency anaesthesia care in a non-theatre location should be cared for by anaesthetists with the same level of competency and assistance as those receiving emergency care in the theatre environment. Certain circumstances may require additional assistance; local arrangements should allow sufficient personnel and resources to support this assistance.85,99
High quality anaesthesia is pivotal to achieving successful outcomes following day surgery. The majority of anaesthesia for day surgery should be delivered by consultant anaesthetists.15,16 staff grade, associate specialist and specialty doctors (SAS) grade doctors and experienced trainee anaesthetists may also provide anaesthesia for day surgery. However, these doctors should be suitably experienced and skilled in...
Adequate recovery room facilities that comply with the Association of Anaesthetists’ recommendations for standards of monitoring during anaesthesia and recovery should be available within the delivery suite theatre complex.43
