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Where transfers between hospitals are foreseeable (e.g. transfers to major trauma, neurosurgical or paediatric centres) local arrangements should be in place to ensure safe and timely transfer, which may involve a retrieval service. Arrangements should be in place for appropriately trained and competent staff, insurance (personal and medical indemnity), crash test compliant equipment, ambulance booking procedures, procedures for receiving patients...
All areas in which emergency anaesthesia is undertaken should be adequately equipped and stocked at all times with the range of equipment and drugs required for immediate use in all types of urgent cases that might be reasonably expected in that hospital area. This would include equipment for children in hospitals accepting paediatric emergencies.
Specialist equipment and drugs that are not commonly used, or that are not time critical, should be available if required.
In recent years there has been a trend towards assessment of elective patients in preadmission clinics, typically one to two weeks before surgery. This allows routine paperwork and investigations to be completed before admission, permits ‘same day’ admission and reduces the likelihood of delays or cancellation.48,49,50,51 Anaesthetists should be part of the preadmission clinical...
Medication errors are consistently the second highest type of errors reported in anaesthetic practice and so all staff involved in the prescribing, preparation, administration and monitoring of drugs must be appropriately trained.82
Hospitals should ensure that staff are trained and competent to use the equipment provided. Equipment should be properly maintained and replaced in a timely and planned fashion.83,84
Theatre operating tables should be available for all types of surgery undertaken, including imaging access (carbon fibre), and adjuncts for safe positioning and transfer. Specialist operating tables, transfer equipment and positioning aids should be available for obese patients.85
There must be appropriate equipment available for transfer of the patient within the theatre, together with the appropriate staff trained to use it safely.83,86,87
There must be full provision of personal protective equipment and shields from blood spray, radiation and hazardous substances for all staff working in the operating theatre, and guidance provided on its usage.86,88,89
Near patient testing for haemoglobin, blood gases, lactate, blood sugar and ketones should be readily available for theatres.
