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It is recognised that in smaller units, it may be difficult to have a duty anaesthetist exclusively dedicated to the delivery unit. If the duty anaesthetist has other responsibilities, these should be of a nature that would allow the activity to be immediately delayed or interrupted should obstetric work arise. Under these circumstances, the duty anaesthetist should be able to...
Adequate time for formal handover between shifts should be built into the timetable.
A structured tool should be considered to facilitate handover.25
The duty anaesthetist should participate in delivery suite ward rounds.26
Hospitals admitting emergency surgical patients should provide, at all times, a dedicated, fully staffed, operating theatre appropriate to the clinical workload that they accept. There should be provision to increase resources if necessary to manage fluctuating work load demands and still provide an acceptable standard of care.13,33,42
At all times, there should be an on site anaesthetist who has the ability and training to undertake immediate clinical care of all emergency surgical patients. Explicit arrangements should be in place to provide support from additional anaesthetists appropriate to local circumstances.
The emergency anaesthesia team should be led by a consultant anaesthetist and include all medical and other healthcare professionals involved in the delivery of anaesthesia for emergency surgery.13,43 Part of this role should include liaison with other departments such as radiology, medicine and emergency departments (ED).
All patients should have a named and documented supervisory consultant anaesthetist who has overall responsibility for the care of the patient.44,45 A suitably trained and experienced staff grade, associate specialist and specialty (SAS) doctor could be the named anaesthetist on the anaesthetic record if local governance arrangements have agreed in advance that the individual doctor can take...
Whenever emergency surgery is undertaken, the post-anaesthesia care unit (PACU) should be open continuously and adequately staffed.47 Until patients can maintain their own airway, breathing and circulation, they should be cared for on a one-to-one basis, with an additional member of staff available at all times.44
Recovery staff should have immediate access to the appropriate clinician in the perioperative period, e.g. anaesthetist, surgeon, radiologist.
