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When a child undergoes anaesthesia or an anaesthetic department provides sedation services, there should be a dedicated trained assistant (i.e. an operating department practitioner or equivalent) who has had paediatric experience and maintained their paediatric competencies.¹¹

In non-specialist paediatric tertiary centres (see Glossary), when a child undergoes anaesthesia or an anaesthetic department provides sedation services, departments should consider allocating two ODPs to a list that includes infants. This facilitates paediatric experience and maintenance of competencies within the anaesthesia team.

Equipment should be available and maintained that is appropriate for use in neonates, infants and children of all sizes and ages, including:

• equipment for airway management and monitoring airway patency, including video laryngoscopy and capnography in an easily accessible location.¹⁶ A standardised paediatric difficult airway trolley should be located in areas of the hospital where paediatric airway management...

Equipment for near patient testing of glucose, haemoglobin, blood gases and electrolytes should be readily available. In situations where major blood loss is anticipated, access to thromboelastography, blood cell salvage techniques and haematology laboratory should be considered.²⁰

Intravenous fluid management should conform to NICE guidelines, and appropriate equipment to deliver this safely and accurately should be available.²⁰

Resuscitation drugs and equipment, including an appropriate defibrillator, cuffed tracheal tubes of various sizes and a cuff pressure gauge should be readily available wherever children are anaesthetised.^13,21,22,23

There should be ventilators available that have the flexibility to be used over a wide size and age range, and that provide accurate pressure control and positive end-expiratory pressure.

Theatre temperature should be capable of regulation to at least 23°C, and up to 28°C where neonatal surgery is performed. There should be accurate thermostatic controls that permit rapid change in temperature.

All children and young people should expect to have a preassessment prior to the day of their procedure that meets the medical, physical and emotional needs of that family. The Best Practice Guidance: Preassessment Services for Children undergoing Surgery or Procedures describes the establishment and delivery of a paediatric preassessment service in any hospital where children aged 0-18 years of...

Children undergoing anaesthesia and their families should be offered input from play specialists to help to prepare the child for anaesthesia.²⁵