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Patients presenting with impending airway obstruction may need emergency airway intervention and surgery. The ability to provide this service dictates that an appropriately staffed and equipped theatre be available 24/7.

The location of the head and neck ward should ideally facilitate a rapid return to theatre should the need arise, since postoperative airway complications can occur following even minor surgical procedures. Consideration should be given to the proximity between head and neck wards, theatre, and critical care facilities when planning head and neck services.

Throat packs are no longer recommended for routine insertion, but should their use be judged necessary a protocol governing their use should exist.²³

Patients requiring head and neck procedures should be managed by anaesthetists who have had an appropriate level of training in this field and who have acquired the relevant knowledge and skills needed to care for these patients.^41,42

In order to maintain the necessary repertoire of skills, consultant anaesthetists and SAS doctors providing a head and neck service should have a regular commitment to the specialty, and adequate time should be made available for them to participate in a range of relevant continuing medical education activities, including simulation, human factors and team training.^7,43,44

Head and neck surgery provides an excellent opportunity for the formal and systematic training of anaesthetists in the use of advanced methods for airway management and the shared airway, including videolaryngoscopy, fibreoptic intubation, and jet and apnoeic oxygenation techniques. Where possible, additional equipment such as monitors, video recorders and airway simulators should be made available to facilitate this important aspect...

All hospitals providing care to tracheostomy patients should have trained staff (medical and nursing) available to care for these patients. Training should be regularly updated.^11,45

Departments providing head and neck LASER surgery must have staff trained in the safe use of LASERS and these staff should be available for all LASER cases.^13,14 Training should be regularly updated, and opportunities made available for education in safe LASER use in the theatre complex. Staff involved in LASER surgery should be trained in how to...

All theatre staff should participate in the World Health Organization checklist process (or an appropriate locally agreed process), with reference made to specific airway strategies for anticipated airway problems and to ensure that all necessary equipment is available.¹⁰

Airway management should be guided by local protocols,¹⁰ including formal adoption of national guidelines such as Difficult Airway Society intubation, extubation, paediatric and obstetric guidelines. These protocols should be reviewed and amended when an increased risk of infectivity during aerosol generating procedures is identified to ensure the safety of patients as well as their healthcare providers. ^{17,47,47,49,50}