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Patients recovering from anaesthesia or all depths of sedation including mild sedation (see Glossary) in a non-theatre environment should receive the same standard of care as that required in an operating theatre.^10,11

The requirements for non-theatre anaesthesia services out of hours should be locally agreed and sufficient staffing should be in place to deliver all aspects of the emergency workload without compromising patient safety.¹²

If a radiology department provides an emergency interventional service for which anaesthesia services may be required, plans for staffing this anaesthetic service should be made, particularly outside normal working hours. Clear referral pathways for anaesthetic support for interventional radiology should be provided for all hours the service is offered.^13,14,15,16

Anaesthesia for non-theatre environment should be delivered by a competent individual with appropriate supervision; the level of supervision should reflect the severity of the case and the seniority of the individual in accordance with the RCoA's Guidance on Supervision Arrangements for Anaesthetists.¹⁷

Anaesthetists in training should be given the appropriate level of responsibility according to their competence and level of training, to gain the experience of non-theatre environment and to enable them to function as a consultant later in their career. Anaesthetists in training must be appropriately supervised at all times; rotas and staffing arrangements should be in place to facilitate this...

Equipment for the minimum standards of monitoring should be available at all sites where patients receive anaesthesia or sedation.²² For patients receiving conscious sedation, this should include pulse oximetry.

Continuous waveform capnography should be available for all patients undergoing general anaesthesia and moderate or deep sedation.^22,23

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...

Where piped oxygen is used, back-up cylinders should always be available and should be appropriately stored.

All anaesthetic equipment should be standardised (where possible) in all areas providing anaesthetic services, including equipment for resuscitation and life support with the exception of any equipment that needs to be magnetic-resonance (MR) safe. All anaesthetic equipment should be subjected to a standardised programme of maintenance.²¹