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Local anaesthetic solutions intended for epidural infusion should be stored separately from intravenous infusion solutions to minimise the risk of accidental intravenous administration of such drugs.⁶⁴

Medication for rare but life threatening anaesthetic emergencies, in particular Intralipid, sugammadex and dantrolene, should be immediately available to the delivery suite, and their location should be clearly identified. There should be a clear local agreement on the responsibility for maintenance of these emergency medicines, i.e. regular checks of stock levels, integrity, and expiry dates.

Physiotherapy services should be available 24/7 for patients requiring high dependency care.

There should be easy and safe access to the delivery suite from the main hospital at all times.

An emergency call system should be provided.

There should be at least one fully equipped obstetric theatre within the delivery suite, or immediately adjacent to it. Appropriately trained staff should be available to allow emergency operative deliveries to be undertaken without delay.²¹ The number of operating theatres available for obstetric procedures will depend on the number of deliveries and the operative risk profile of the women...

There should be medication storage facilities within maternity theatres which provide timely access to medicines when clinically required, while maintaining integrity of the medicinal product and allowing the organisation to comply with safe and secure storage of medicines regulations.^62,65

Adequate recovery room facilities, including the ability to monitor blood pressure, ECG, oxygen saturation, end-tidal carbon dioxide and temperature, should be available within the delivery suite theatre complex.⁴¹

High-risk surgical patients should have their predicted 30-day mortality recorded preoperatively. The National Confidential Enquiry into Patient Outcome and Death report on high-risk surgery recommended the assessment and recording of 30-day predicted mortality for high-risk surgery (defined as a greater than 5% risk).⁶³ The national emergency laparotomy audit and the national hip fracture database both recommend the recording of...

Patient controlled analgesia (PCA) equipment should be available for postoperative pain relief, and staff operating it should be trained in its use and how to look after women with PCA.⁴⁸