Research in anaesthesia for burn and plastic surgery should be encouraged. Staff members undertaking research should have received appropriate training.69
When an awake fibre-optic intubation is required, patients should be informed. As part of a difficult airway follow up, patients should be informed verbally and in writing about any airway problem the anaesthetist encountered, and be advised to bring this to the attention of anaesthetists during any future preoperative assessment. The patient’s GP should also be informed in writing.70
Where alternative techniques are available, the patient’s preference must be fully taken into account.71
All major head and neck surgery should be overseen by a named consultant anaesthetist with a subspecialty interest in this area.50
Patients should not unnecessarily undergo surgery at night. In order to prevent this, planned operating lists may be necessary in the evening and weekend, in addition to scheduled weekday trauma sessions.50
A named anaesthetist should oversee the provision and management of anaesthetic equipment.33
Any scheduled plastic surgery trauma lists should be organised and staffed by senior anaesthetists and surgeons, working regularly in that area and without conflicting clinical commitments.50
Departments should develop and regularly review burn and plastic surgery referral guidelines and major incident plans.53
Agreed local clinical guidelines should be in use, produced by an appropriately constituted multiprofessional team, comprising anaesthetists, specialist nurses, surgeons, critical care clinicians, pharmacists, specialty consultants and managers. These guidelines should cover at least the following:
Each unit should have a designated clinical lead (see glossary) anaesthetist who is responsible for cardiac anaesthesia services. This should be recognised in their job plan and they should be involved in multidisciplinary service planning and governance within the unit.
