Anaesthetists with responsibility for the intraoperative care of trauma patients should ensure that their skills and knowledge of current recommendations are up to date, particularly in the management of major haemorrhage.
An anaesthetist should be involved in all case reviews where the case includes anaesthetic input.2
Consultants or autonomously practising anaesthetists providing anaesthesia for lung transplantation should have appropriate training and substantial experience of advanced cardiorespiratory monitoring and support.
Service developments outside the operating theatre often place unintended demands on anaesthetists. The business plans for such services should include provision for anaesthetic services.
A named anaesthetist with time assigned in their job plan should oversee the provision and management of anaesthetic equipment.139
An anaesthetist should have overall responsibility for the transport of patients from theatre to the recovery unit.180
The patients’ anaesthetist should retain overall responsibility for the patient during the recovery period and should be readily available for consultation until the patient is able to maintain their own airway, has regained respiratory and cardiovascular stability and is able to communicate, unless this care has been handed over to another named anaesthetist
An anaesthetist should be physically present when a general anaesthetic is administered. In exceptional circumstances, anaesthetists working singlehandedly may be called on briefly to assist with or perform a lifesaving procedure nearby. This is a matter for individual judgement, and the dedicated anaesthetic assistant should be present to monitor the unattended patient.8
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.
The use of extracorporeal membrane oxygenation (ECMO) for the management of adults with severe respiratory failure is currently confined to five UK cardiothoracic centres. Anaesthetists often institute ECMO and support retrieval of patients from non-specialist hospitals. Anaesthetists providing ECMO should be suitably trained.54
