Chapter 18: Guidelines for the Provision of Anaesthesia Services for Cardiac and Thoracic Procedures 2021
Equipment for temporary pacing should be available.
Equipment for temporary pacing should be available.
Fibreoptic bronchoscopy should be immediately available for all cases where lung isolation is used.21
Dedicated equipment for jet ventilation should be available for interventional airway procedures.24
Designated thoracic, cardiac or cardiothoracic wards should be considered.
Cardiac and thoracic surgery should ideally be performed in dedicated operating rooms. It is unlikely that an operating room will be kept available at all times for emergencies. Local arrangements for urgent and emergency cases should be in place.
In some centres, selected cardiac surgical patients are managed in facilities other than designated ICUs following surgery. These are variously referred to as the high dependency unit (HDU), cardiac recovery or cardiac fast-track unit. These areas aim to minimise the period of mechanical ventilation. The equipment, monitoring and staffing requirements for such a facility are no less than the requirements...
Facilities should be available for the decontamination and safe storage of transoesophageal echocardiography probes in line with local and national recommendations.25,26,27 There should also be a method to report, archive and retrieve all echocardiography studies performed in cardiac theatres. Major complications related to transoesophageal echocardiography should be monitored.28
After major thoracic surgery, patients should be transferred to an appropriately sized, equipped and staffed post-anaesthetic recovery area. Planned or emergency access to ICU or HDU should be available.31
Non-invasive ventilation facilities should be available in the immediate postoperative period, for example bilevel positive airway pressure (BiPAP), continuous positive airway pressure (CPAP) and high-flow nasal oxygen therapy (HFNO).32
Access to theatres and associated clinical areas should be appropriately restricted.7