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Consultant anaesthetists intending to follow a career in paediatric cardiothoracic anaesthesia should have higher training in general paediatric anaesthesia of at least one year followed by a specialist training period of an appropriate duration in the subspecialty.
All staff should have access to adequate time, funding and facilities to undertake and update training that is relevant to their clinical practice, including annual mandatory training such as basic life support.
Fellowship posts should be identified to allow additional training for those who wish to follow a career in cardiac or thoracic anaesthesia to help ensure there are adequate numbers of skilled anaesthetists in the specialty. These should be suitable for trainees who wish to take time out of training programmes, or for those who are post certificate of completion of...
Departments should consider providing all newly appointed consultants, particularly those with limited experience, with a mentor to facilitate their development in cardiac or thoracic anaesthesia.
Some patients who are housebound and have difficulty in accessing primary or secondary care may benefit from a home visit for their preoperative assessment and preparation. The same may apply to prisoners detained in HM Prison Service.
Theatre and anaesthetic related equipment should always be equivalent to that provided for inpatient surgery. It should be regularly maintained and where possible standardised across all theatre suites within a hospital.24
The recommended Association of Anaesthetists standards of anaesthetic monitoring should be met for every patient.25
Full resuscitation equipment and drugs should be provided as outlined by the Resuscitation Council and hospital policy.26
Peripheral nerve blocks, spinal anaesthesia and intravenous regional anaesthesia often provide excellent conditions for day surgery.27,28,29 Equipment to facilitate these techniques, such as nerve stimulators and ultrasound machines, neuraxial e.g. NRfit needles and syringes should be available.
Short acting anaesthetic drugs and appropriate equipment to facilitate their delivery should be available in day surgery units.