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The recommended standards of monitoring, by instrument or otherwise, should be met for every patient.⁴

24/7 access to cardiac electrophysiology services should be available.

Children undergoing cardiac and thoracic procedures have special requirements and the responsibility for paediatric anaesthetic care may be shared with paediatric anaesthetists.⁴²

Paediatric cardiac surgical patients should be cared for in a unit designed and equipped to care for paediatric patients and staffed by appropriately trained nurses. Such a unit should meet the standards defined for paediatric critical care, including adequate arrangements for retrieval and transfer of patients.^43,44

Anaesthetists should be aware of legislation and good practice guidance⁴⁵ relevant to children and according to the location in the UK.^46,47,48,49 These documents refer to the rights of the child, child protection processes and consent.

Children currently transition to adult congenital heart disease services at the age of 16–18 years, although transition services are integrated into the care pathway from age 12 years. Anaesthetists should be aware of legislation and good practice guidance relevant to young and vulnerable adults.^45,51

Specialist anaesthetists should be involved in the discussion of referrals and planning when this is conducted in the setting of a multidisciplinary team. This should be recognised in job plans.

Consultants providing anaesthesia for heart or lung transplantation should have appropriate training and substantial experience of advanced cardiovascular monitoring and support.

Cardiothoracic anaesthetists working in non-transplant centres should be familiar with the principles of the anaesthetic management of patients who have previously undergone heart or lung transplantation.⁴⁹

Patients undergoing lung transplantation may be under the age of 18 years. Anaesthetists must be aware of legislation and good practice guidance relevant to young and vulnerable adults.^45,51 Children undergoing transplantation should be cared for in a paediatric centre.