Facilities to check recent serum electrolytes, in particular potassium and preferably magnesium, as well as the patient’s anticoagulation status and a recent ECG should be available before beginning a DC cardioversion. A preprocedural echocardiogram is likely to provide useful information such as the presence of thrombus within the cardiac chambers.72
The anaesthetist should not be responsible for performing the cardioversion; an appropriately trained physician, cardiologist or supervised nurse specialist is responsible for this role.50
Standards of service provided to patients receiving endoscopic procedures supported by anaesthetic staff in the non-theatre environment should be comparable to other anaesthetic services.
Anaesthetic staff providing care in the endoscopy suite should be familiar with the facility, equipment and techniques.
Preoperative assessment of elective patients receiving anaesthesia or sedation from anaesthetic personnel should be of a comparable standard to other anaesthesia services.
The risks of serious adverse events during emergency endoscopy are elevated when compared with elective procedures. Local protocols should include specific guidelines for emergency endoscopy and the involvement of the anaesthetic team.
A patient-centred safety checklist should be used for patients receiving endoscopy under sedation.78
Monitoring of patients receiving anaesthesia or sedation for endoscopy provided by anaesthetic personnel should be comparable to other anaesthesia services.
High-flow nasal oxygen therapy should be available for anaesthesia-delivered sedation or general anaesthesia for endoscopic procedures.
The post-anaesthetic recovery facilities when provided for patients following anaesthesia delivered sedation or anaesthesia should be comparable to those provided in theatre environments. The provision of a handover checklist can improve the transfer of care in the recovery setting conveying pertinent clinical and procedural information.
