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Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
A policy should be in place for the management of non-peripartum pregnant women. This should detail the involvement of the multidisciplinary obstetric team, including midwives, neonatologists and obstetricians, depending on gestational stage.224
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
A policy should be in place for the perioperative care of breastfeeding mothers. This should include guidance to staff on the requirements to facilitate breastfeeding, anaesthesia protocols for breastfeeding mothers, outline supportive measures and provide clear instructions for the patient pre and post anaesthesia or sedation.225
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
Preoperative assessment, optimisation and shared decision making in patients with multiple comorbidities, frailty or cognitive impairment require a cross specialty approach involving anaesthetists, surgeons, geriatricians, pharmacists and allied health professionals. Liaison with a clinical pharmacist in the perioperative period will enable optimisation of medicines and improved management of the patients’ non-surgical comorbidities during this time. The development of such teams...
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
Care of the frail and older surgical patient starts at the contemplation of surgery and continues through the hospital stay and beyond. Models of care for frail and older patients should include multidisciplinary management between surgical teams, physicians with expertise in the assessment and management of frailty/delirium and allied health professionals providing consistent hands-on medical care, direction of rehabilitation goal...
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
Models of care could include comprehensive geriatric assessment which may have potential to improve outcomes.240
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
Older patients should have access to a consultant or other autonomously practising anaesthetist experienced in the management of the older surgical patient to support shared decision making, patient optimisation and perioperative care. Opportunities for joint geriatric and surgical clinical governance should be considered as this model of care is superior to that delivered without this expert support. 229,244,245