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The role of an ‘emergency theatre co-ordinator’ should be considered for departments with a large emergency workload, so that patient flow and prioritisation of cases can be actively managed.¹⁷⁶

A current list of emergencies should be easily accessible to all medical and operating department staff, so that there is shared awareness of the emergency load and resource requirements, within the principles of patient confidentiality.^177,178

The urgency of emergency cases should be clearly and unambiguously coded.¹⁴ There should be regular review of delays to facilitate improved theatre access and to promote accurate urgency coding at booking. Prioritisation of cases based on their urgency is not the sole domain of any single specialty. It requires a team approach involving discussion between different surgical groups, anaesthetists...

The language in all communications relating to the scheduling and listing of procedures must be unambiguous. Laterality must always be written in full, i.e. ‘left or ‘right’.²⁵

Adequate emergency theatre time should be provided throughout the day to minimise delays and avoid emergency surgery being unnecessarily undertaken out of hours when the hospital may have reduced staffing to care for complex postoperative patients. Consideration should be given to consultant, or suitably experienced and trained SAS doctor, staffing of 'twilight' or evening emergency theatre sessions. Job plans may...

Dedicated emergency lists for some individual surgical services, e.g. paediatrics, may be an effective use of resources and improve patient flow and care.⁴¹

Some aspects of preanaesthetic assessment and preparation of the emergency patient differ from those of the elective patient. These include severity of illness, fluctuating condition of the patient, and the 24/7 nature of emergency work. Staffing levels and seniority of anaesthetists should be adequate to enable preanaesthetic planning and assessment that is appropriate to the patient’s risks associated with surgery...

There should be a formalised integrated pathway for unscheduled adult general surgical care which should be patient centred and include:^{1,3,33,41,128}  

• a clear diagnostic and management plan made on admission⁷³
• risk assessment and identification of the high risk patient^1,3,128
• early identification of comorbidities (including diabetes...

All hospitals should have guidelines in place for the recognition and management of patients with sepsis. Compliance with these policies should be regularly audited.^9,104,105

Every hospital should nominate an anaesthetic lead (see glossary) for obesity.³⁵