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Parents and carers should be enabled to remain as close to their child as possible during the process of anaesthesia and recovery. There should be a space available within close proximity to theatres where they can wait and be contacted.

Near patient testing for coagulopathy should be considered, particularly in areas where major blood loss is likely.⁹⁰ If near patient testing is not available laboratory testing should be readily and promptly available.

A fully equipped resuscitation trolley should be available in all areas in which emergency anaesthesia is undertaken. These trolleys should be colour coded and maintain uniformity within the trust, to improve safety.^91,92,93

A difficult airway trolley, including the equipment necessary to manage failed intubation and surgical airway access, should be available in all areas where anaesthesia may be undertaken.^94,95 Equipment for fibre optic intubation and video laryngoscopy should also be available and properly maintained.^94,95,96

Warming devices for patients should be available for use in the anaesthetic room, operating theatre, recovery unit and ED.^97,98

A rapid infuser allowing the infusion of warmed intravenous fluids and blood products should be available.^97,98,99

A cell salvage service should be available for cases where massive blood loss is anticipated. Staff who operate this equipment should receive training in how to operate it, and use it with sufficient frequency to maintain their skills.^98,100

Hospitals should engage with networks in order to develop agreed care pathways based on age, comorbidity and complexity of procedure, as well as clinical urgency. Care pathways should relate to local service provision, staffing and geography.

Hospitals should liaise with the regional network lead for surgery and anaesthesia to provide input to regional audit and standards.

Hospitals that are regional specialist paediatric units should have access to a paediatric critical care transport service commissioned for the retrieval or transfer of critically ill or injured infants, children and young people.¹³