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Departments of anaesthesia must ensure that a named supervisory consultant is available to all non-consultant anaesthetists, except those non-consultant non-trainee anaesthetists that local governance arrangements have agreed in advance are able to work in those circumstances without consultant supervision, based on the training and experience of the individual doctor and the range and scope of their clinical practice.158 Where...
Departments should consider developing diagnostic ultrasound skills as appropriate to emergency anaesthesia. There has been a rise in interest in point of care ultrasound and its extension into emergency anaesthesia and critical care. Diverse applications include haemodynamic assessment and monitoring with echocardiography, assessment of lung and pleura (e.g. pneumothorax or pulmonary oedema), vascular access and evaluating gastric residual volumes prior...
The provision of a high quality emergency service should be an explicit aim of the hospital executive and senior staff team. This should be reflected in hospital published plans and by the provision of a management structure to support this aim.33 The required standards set out in this document apply to all organisations, but the methods used to achieve...
Organisations should explicitly recognise the 24/7 nature of emergency work, and this requires a specific organisational approach for standards to be achieved throughout the whole of the week.
The hospital business plan should address the predicted growth in surgical emergencies, ageing population and any changes as a result of regional specialisation.29,127,165,166,167 Future planning should be based on accurate and timely data. Mathematical modelling for matching theatre demand and capacity could be beneficial.168
Each department of anaesthesia should have a plan in place for the emergency anaesthetic workload to be delivered effectively and safely.169
Hospitals should have a clear and explicit strategy for developing a strong safety culture that includes the following characteristics: recognition of the inevitability of errors, commitment to discuss and learn from errors, proactive identification of latent threats, and the incorporation of non punitive systems for reporting and analysing adverse events.59,170,171
Information on the risks and the common side effects of anaesthesia in children should be discussed and offered in writing to children, parents and guardians.16
Hospitals should review their local standards to ensure that they are harmonised with the relevant national safety standards, e.g. National Safety Standards for Invasive Procedures in England or the Scottish Patient Safety Programme in Scotland. 25,172
The organisational culture should seek to empower health professionals to implement the patients’ preferences, informed by discussions around risk and benefit. Healthcare should be organised from the bottom up, with ownership and decision making in the hands of professionals and patients. 2,16,152,173
