Hospitals should have approved documentation defining safe staffing levels for anaesthetists and anaesthetic practitioners, including contingency arrangements for managing staffing shortfalls; annual reviews of compliance with these standards should be performed.
Blood gas analysis (with the facility to measure serum lactate and the facility for rapid estimation of haemoglobin and blood sugar) should be available on the delivery suite.
Delivery suite rooms should be equipped with monitoring equipment to measure non-invasive blood pressure, oxygen saturation and heart rate.
Delivery suite rooms should have oxygen, suction equipment and access to resuscitation equipment. This equipment should be checked daily.41
Delivery suite rooms must comply with Control of Substances Hazardous to Health Regulations 2002 and guidelines on workplace exposure limits on waste gas pollution.42
The standard of monitoring in the obstetric theatre should comply with Association of Anaesthetists standards of monitoring.43
A fluid warming device allowing rapid infusion of blood products and intravenous fluids should be immediately available to the delivery suite.44
In tertiary units with a high-risk population it is recommended that there should be equipment to enable near-patient estimation of coagulation.44
Cell salvage may be considered for women who refuse blood products or where massive obstetric haemorrhage is anticipated but it should not be used routinely for caesarean birth. When cell salvage is required, staff who operate this equipment should have received training and should maintain the appropriate skills to continue to do so.45,46,47,48
