Chapter 18: Guidelines for the Provision of Anaesthesia Services for Cardiac and Thoracic Procedures 2021
Cardiac patients are often at high risk of cardiac arrest. Sufficient space and facilities should be available for managing this eventuality.
Cardiac patients are often at high risk of cardiac arrest. Sufficient space and facilities should be available for managing this eventuality.
Cardiovascular instability may, on occasion, necessitate the use of extracorporeal support. Catheter laboratories should have sufficient space, medical gas outlets, electrical sockets, network sockets, and other essential facilities to meet this demand.
Where revision of rhythm management devices is considered to be pose high risk of requiring emergency surgical intervention, cardiopulmonary bypass equipment and a plan for surgery should be available at the start of the procedure.
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.57 Anaesthetists should be part of the preadmission clinical pathway, including implementing interventions to...
Cardiac and thoracic anaesthesia is a ‘key unit of training’ for intermediate level training in anaesthesia.61 Trainee anaesthetists should be of appropriate seniority to be able to benefit from this area of training.
All trainees should be appropriately clinically supervised at all times.62
Trainees should have an appropriate balance between thoracic, cardiac and ICU training based on their individual requirements.63
Trainees planning to embark in a career in cardiac anaesthesia should be encouraged to undertake training and accreditation in transoesophageal echocardiography.39
Consultant anaesthetists intending to undertake anaesthesia for cardiac or thoracic surgery should have received training to a higher level in cardiac and/or thoracic anaesthesia, for a minimum of one year in recognised training centres, as part of general training.61 Those providing critical care for cardiac surgical patients should have received training to the minimum level as defined by the...