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The following ancillary anaesthetic equipment is required for the safe delivery of anaesthesia, and should also be available at all sites where patients are anaesthetised:
- oxygen supply
- self-inflating bag
- facemasks
- suction
- airways (nasopharyngeal and oropharyngeal)
- laryngoscopes including videolaryngoscopes and fibreoptic scopes as clinically required
- appropriate range of tracheal tubes and connectors
- intubation aids (bougies, forceps, etc)
- supraglottic airways
- heat and...
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 be able to support quality improvement initiatives. Sufficient time should be included in job plans to support these activities and the continuing professional development of those anaesthetists.
A difficult airway trolley, including the equipment necessary for failed intubation and surgical airway access, should be available.14 Appropriate specialist intubation equipment, including fibre-optic intubation equipment should be available. A fibre-optic scope should be available to assess inhalational injury.15,16,17,18,19
Equipment necessary for the formation of a surgical airway, including cricothyroidotomy, should be available.20
Ventilators with advanced ventilatory mode functions should be available.21
Equipment to comply with the Association of Anaesthetists standards for anaesthetic monitoring should be available.23
Pulse-oximetry ear probes should be available.22
It may be difficult to make the electrocardiogram (ECG) gel electrodes adhere to damaged skin. ECG electrodes could be sited away from the chest22 or could be attached to crocodile clips, surgical staples or steel sutures placed in burned areas.15,19,24
Invasive arterial blood pressure monitoring should be available for extensive burn debridement and major plastic surgery, to allow the benefits of continuous pressure monitoring, pulse-contour analysis and ease of blood sampling.15,18,19,24
An arterial blood-gas machine should be immediately available.