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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...

An anaesthetic preoperative assessment service should involve consultant anaesthetists and staff grade, specialty and associate specialist (SAS) doctors.^41,42,44 Dedicated anaesthetic presence in the preoperative assessment and preparation clinic is required for:

• the review of results and concerns identified by preoperative staff
• consultations with patients identified using a triage process to allow optimal delivery of preoperative...