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There should be provision for a high level of care for emergency patients where necessary.⁴

Critical care should be considered for all high-risk patients requiring emergency surgery. As a minimum, patients with an estimated risk of mortality of 5% or higher should be considered for critical care and should be reviewed by a consultant surgeon, consultant anaesthetist and consultant intensivist before surgery.^5,130  

There should be locally agreed protocols for postoperative critical care admission that comply with national standards, and compliance with these protocols should be audited.

Hospital level audit data should be examined to determine whether national standards for postoperative critical care admission are being adhered to. Where compliance is poor, a change of local policies and reconfiguration of services should be considered, to enable all high risk emergency patients to be cared for on a critical care unit after surgery.²

Facilities to enable immediate life, limb or organ saving surgery should be available at hospitals accepting emergency surgical patients. Sites that accept patients for emergency surgery should ensure access to all core specialties,  including postoperative care facilities, a full range of laboratory and radiological services and sufficient critical care capacity appropriate to the case load and case mix.^2,60,124,125 

Explicit arrangements should be made for the provision of care from specialties that are not available on site (e.g. neurosurgery, cardiothoracic, vascular, ear, nose and throat, maxillofacial, hepatobiliary, burns and plastic surgery, geriatric medicine, palliative care medicine).