Group O Rhesus negative blood should be immediately (see Glossary) available. To enable immediate availability, most units will require a blood fridge located within the delivery suite.
There should be rapid availability of radiology services.65
Echocardiography services should be available at all times in units that routinely deal with cardiac patients.6
There should be access to a clinical pharmacist of an appropriate competency level and expertise in obstetrics. They should advise on day-to-day medication or prescribing issues in the obstetric population and should provide input in local policies and procedures about any aspects of medicines management.71,72 Where possible, hospitals should follow national guidance for drug shortages and this should guide local practice.73
Preprepared drugs should be used where available, including sterile ampoules or bags of low-dose local anaesthetic combined with opioid solutions for regional analgesia. Prefilled syringes of commonly used emergency drugs (e.g. suxamethonium and phenylephrine) should be used where available.74
Local anaesthetic solutions intended for epidural infusion should be stored separately from intravenous infusion solutions to minimise the risk of accidental intravenous administration of such drugs.75
Medication for life threatening anaesthetic emergencies should be immediately available to the delivery suite and their location should be clearly identified. There should be a clear local agreement on the responsibility for maintenance of these emergency medicines (i.e. regular checks of stock levels, integrity and expiry dates).59
Physiotherapy services should be available 24/7 for patients requiring higher levels of care.76
