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The alarm limits on monitors should be set appropriately, and audible alarms should not be inactivated.¹⁰²

End-tidal carbon dioxide (Et CO₂) monitoring should be available in all locations where tracheal intubation occurs and where intubated patients are being cared for. This includes out of theatre areas and transfers.^79,94,102 

Equipment to monitor the depth of neuromuscular blockade should be available for patients receiving neuromuscular blocking drugs and the limitations of qualitative monitoring should be recognised.^102,148

Equipment for monitoring the depth of anaesthesia should be available for patients receiving emergency anaesthesia.^103,148

Invasive cardiovascular monitoring should be immediately available. Equipment required for goal directed therapy should be available for all major surgery and high risk patients.^{102,104,105,106,107}

Departments should consider the appointment of a specified consultant anaesthetist to lead the anaesthetic service for the elderly.⁷

All elderly emergency surgery patients should be serially assessed for multimorbidity, frailty and cognition.^1,6,7

The outcomes following emergency surgery for elderly patients (particularly patients who are either partially or wholly dependent) are considerably worse than for younger patients. Consequently, planning of care and decisions to operate require very careful consideration. This should include discussion of issues around risk versus benefit, futility and realistic longer-term outcomes, e.g. requirement for nursing home care. This should also...

Failure to recognise and treat the deteriorating patient (‘failure to rescue’) has been has been shown to increase mortality, particularly in the elderly surgical patient, and so hospitals should have policies in place to prevent this.^113,114 Audits should be undertaken to ensure the effectiveness and compliance of these policies.

Most children are fit and healthy, and straightforward surgery can be planned on a day case basis. Routine blood testing is rarely necessary. There are exceptions to this such as sickle cell status.^18,19