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Patients requiring planned or emergency burn surgery should be cared for by theatre staff with current experience in burn care.⁴ Anaesthetists who provide emergency care outside burn services should be trained to manage the initial treatment of the patient with severe burns, including timely emergency assessment, resuscitation and transfer to a burns service.

Patients requiring planned or emergency burn surgery should be cared for by theatre staff with current experience in burn care.⁴Anaesthetists who provide emergency care outside burn services should be trained to manage the initial treatment of the patient with severe burns, including timely emergency assessment, resuscitation and transfer to a burns service.

The lead obstetric anaesthetist should be responsible for the overall delivery of the service, which includes ensuring that evidence-based guidelines and protocols are in use and are up to date; monitoring staff training, workforce planning, and service risk management; and ensuring that national specifications are met, and auditing the service against these agreed standards, including anaesthetic complication rates. 

As a basic minimum for any obstetric unit, a consultant anaesthetist should be allocated to ensure consultant cover for the full daytime working week (that is, ensuring that Monday to Friday, morning and afternoon sessions are staffed).²⁴ This is to provide urgent and emergency care, not to undertake elective work.

Anaesthesia Associates (AAs) should work under the supervision of a consultant anaesthetist at all times as outlined by the RCoA.^48,49 In some emergency situations, a ratio of 1:1 may be more appropriate in view of the high incidence of comorbidities, complications and mortality.

Postmenarcheal female patients should be made aware of the need for clinicians to establish pregnancy status before surgery or procedures involving anaesthesia. While obtaining and documenting this information is primarily the responsibility of the operating surgeon or paediatrician, anaesthetists may also feel it necessary to confirm that such checks have been performed.⁷³

Complex ophthalmic surgical cases often require specialised anaesthetic input. This may include patients having repeated ophthalmic procedures, long and difficult cases, and those potentially requiring specialist intravenous drug therapy, such as IV steroids, acetazolamide or mannitol. An anaesthetist of appropriate experience should have sole responsibility for operating lists containing such complex cases.

Hospitals should have well integrated arrangements that ensure anaesthetists covering long neurosurgical procedures or overrunning lists are regularly relieved by an appropriate colleague for refreshment and comfort breaks.^8,9,10,11

Patients requiring planned or emergency burn surgery should be cared for by theatre staff with current experience in burn care.¹¹ Anaesthetists who provide emergency care outside burn services should be trained to manage the initial treatment of the patient with severe burns, including timely emergency assessment, resuscitation, and transfer to a burns service.

Patients undergoing lung transplantation may be under the age of 18 years. Anaesthetists must be aware of legislation and good practice guidance relevant to young and vulnerable adults.^45,51 Children undergoing transplantation should be cared for in a paediatric centre.