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All anaesthetic equipment should be checked before use in accordance with the Association of Anaesthetists published guidelines.¹² Anaesthetic machine checks should be recorded in a log and on the anaesthetic chart.

All procedures should be compliant with National Safety Standards for Invasive Procedures (NatSSIPs) and the Safe Surgery Checklist.^13,14 An appropriate ‘pre list check’ of the anaesthesia systems, facilities, equipment, supplies and resuscitation equipment should be performed prior to the start of each list.

Wherever anaesthesia or sedation is undertaken, a full range of emergency drugs including specific reversal agents such as naloxone, sugammadex and flumazenil should be made available.

In remote locations where anaesthesia is undertaken, drugs to treat rare situations, such as dantrolene for malignant hyperthermia, or intralipid for local anaesthetic toxicity should be immediately available and located in a designated area.

There must be a system for ordering, storage, recording and auditing of controlled drugs in all areas where they are used, in accordance with legislation.^{15,16,17,18,19}

Robust systems should be in place to ensure reliable medicines management, including storage facilities, stock review, supply, expiry checks, and access to appropriately trained pharmacy staff to manage any drug shortages.^19,20

All local anaesthetic solutions should be stored separately from intravenous infusion solutions, to reduce the risk of accidental intravenous administration of such drugs.^19,21

All drug containing infusions and syringes should be clearly labelled.^19,22

The anaesthetist should consider all environmental factors when planning administration of anaesthesia or sedation.

When rooms are darkened hindering direct observation of the patient, availability of an alternative light source to record notes and observe the patient should be considered.