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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. There should be the same access to anaesthetic equipment, monitoring, drugs and personnel as in the theatre environment. Certain circumstances may require additional assistance, and local arrangements should...

In situ simulation training can help to identify system process gaps.⁹² Simulation-based learning techniques should be used to assist anaesthetists to resolve these issues and develop the necessary technical and non-technical skills.^{93,94,95,96,97,98,99,100,101,102,103}

Anaesthetists who do not have regular children’s lists but who do have both daytime and out of hours responsibility for providing care for children requiring emergency surgery should maintain appropriate clinical skills. There should be arrangements for undertaking regular supernumerary attachments to lists or secondments to specialist centres. The Certificate of Fitness for Honorary Practice ⁶⁰ may facilitate such placements...

Anaesthetists should be familiar with the specific needs of patients with cancer, including the following:

• the adverse effects of high concentrations of oxygen in the presence of some antineoplastic agents, for example bleomycin, and should adjust their technique accordingly.[i]^,[ii] Recent evidence confirms the association between unnecessarily high intraoperative fraction of inspired oxygen and increased risk of...

The lead obstetric anaesthetist should be responsible for the overall delivery of the service, including:

• ensuring that evidence based guidelines and protocols are in use and are up to date
• monitoring staff training
• workforce planning
• service risk management
• ensuring that national specifications are met
• auditing the service against agreed standards, including anaesthetic complication rates, as set out in the RCoA ...

Where ophthalmic surgery is performed as a daycase procedure, the facilities should conform to best practice guidance. Day surgery operating theatres should meet the same standards as inpatient operating theatres.^24,25,26 Room should be available for patients to be seen in private by the anaesthetist and surgeon on the day of surgery.²There should...