Head and neck surgery includes a wide spectrum of surgical interventions, ranging from short daycase procedures to long and complex operations.1 The requirements for providing anaesthesia services for routine head and neck surgery, such as tonsillectomy, will be different to those required to provide anaesthesia for major or complex surgery. There should be recognition that routine head...
It is important to engage in a shared decision-making process with patients to discuss the risks and benefits of scheduled or elective major vascular surgery. Details should be explained to the patient in an appropriate setting and in language they can understand. Patient information materials should be made available to support the patient’s decision with regard to choices on anaesthesia...
These discussions should occur well in advance of planned surgery to allow reflection and informed decision-making. All such discussions should be documented, although it is still necessary to give relevant explanations at the time of the procedure.
Options for anaesthesia and all aspects of perioperative care, including risks and benefits, should be discussed with the patient by the responsible anaesthetist.
Information about anaesthesia during vascular surgery such as the Royal College of Anaesthetist’s ‘Your anaesthetic for vascular surgery’ leaflet should be available.47
In all hospitals undertaking major vascular anaesthesia a vascular anaesthetist should be appointed clinical lead (see glossary) to manage service delivery. This should be recognised in their job plan, and they should be involved in multidisciplinary service planning and governance within the unit.
Anaesthesia for all patients undergoing major vascular surgery should be provided by or directly supervised by an anaesthetist suitably qualified, trained and experienced in vascular anaesthesia. This will be a consultant or other autonomously practicing vascular anaesthetist, who has overall responsibility for the patient’s care. 18
It is recognised that staff involved in providing care for out-of-hours vascular emergencies may differ from those involved in routine daytime care. It is essential that all staff who might potentially be involved in perioperative care of the emergency vascular surgical patient are trained and competent in the aspects of care for which they are responsible. There should be provision...
Anaesthetists undertaking major vascular surgical cases should be supported by adequately trained assistants who work regularly in the vascular theatres.
