All anaesthetists and the wider theatre team should be aware of the serious complications of regional anaesthesia including wrong sided block and local anaesthetic systemic toxicity. Anaesthetists should help organise and participate in regular multidisciplinary training aimed at reducing risk, recognition and management.
The anaesthetist should ensure that an adequate supply of oxygen is available before starting any procedure. Many of the sites where anaesthesia is provided outside the main operating theatres do not have piped oxygen; if anaesthesia is provided frequently in such a location, the use of the location should be reviewed, or piped oxygen provided. The organisational culture should enable...
A clinical lead for burn and plastic surgery anaesthesia should be appointed in each hospital providing anaesthesia for this specialty. The clinical lead (see Glossary) anaesthetist in burn and plastic surgery units will be responsible for the provision of service, teaching, production of guidelines, management, research and audit, and should be able to support quality improvement initiatives. Sufficient time...
The care of the patient should remain the responsibility of the anaesthetist up to discharge for ambulatory procedures or ward transfer for inpatient procedures.
There should be sufficient programmed activity time available for anaesthetists to assess patients perioperatively and to attend multidisciplinary ward rounds.
Wherever sedation services for paediatric burn management exist, anaesthetists should be involved with setting up, monitoring and auditing the service.
There should be a joint forum for discussion of matters relevant to both surgeons and anaesthetists, for example protocol development and critical incidents.
Ideally, patients with morbid obesity should undergo preassessment by a senior anaesthetist.256
