Search

Regional analgesia should not be used in labour unless the obstetric team is immediately available.

There should be a locally developed regional analgesia record and a protocol for the prescription and administration of drugs.

When the anaesthetist is informed of a request for regional analgesia (and the circumstances would be suitable for this type of analgesia) the anaesthetist should attend within 30 minutes of being informed. Only in exceptional circumstances should this period be longer, and in all cases attendance should be within one hour. There should be a clear escalation plan for instances where...

Units that provide remifentanil patient controlled anaesthesia for labour analgesia should have policies and processes in place to ensure that it is used safely, that midwives who care for women using it are familiar with its use and have received specific training. Unit staffing levels should permit continuous midwifery supervision of its use.

There should be a clear line of communication between the duty anaesthetist, theatre staff and anaesthetic practitioner once a decision is made to undertake an emergency caesarean birth.

The anaesthetist should be informed about the category of urgency of caesarean birth and the indication for surgery at the earliest opportunity.¹⁴⁷

A World Health Organization (WHO) checklist adapted for maternity should be used in theatre.¹⁴⁸

There should be clear arrangements for contingency plans and an escalation policy should two emergencies occur simultaneously, including whom to call.

Team briefing and the WHO checklist should be in routine use on the labour ward to promote good communication and teamworking and reduce adverse incidents.^{147,148,149,150}

If any major restructuring of the provision of local maternity services are planned, the lead obstetric anaesthetist should be involved in that process.^22,25