Cardiac patients are often at high risk of cardiac arrest. Sufficient space and facilities should be available for managing this eventuality. Transoesophageal echocardiography should be immediately available.
Cardiovascular instability may, on occasion, necessitate the use of extracorporeal support, including cardiopulmonary bypass. Catheter laboratories should have sufficient space, medical gas outlets, electrical sockets, network sockets and other essential facilities to meet this demand.
Where revision of rhythm management devices is considered to pose a high risk of requiring emergency surgical intervention, cardiopulmonary bypass equipment and a plan for surgery should be available at the start of the procedure.47
Cardiac anaesthesia is a ‘key unit of training’ for stage 2 training in anaesthesia.42 Trainee anaesthetists should be of appropriate seniority to be able to benefit from this area of training.
All anaesthetists in training should be appropriately clinically supervised at all times.52
Trainees should have an appropriate balance between cardiac and ICU training based on their individual requirements.
Trainees planning to embark in a career in cardiac anaesthesia should undertake training and accreditation in transoesophageal echocardiography.50
Consultant or autonomously practising anaesthetists intending to undertake anaesthesia for cardiac surgery should have received training to a higher level in cardiac anaesthesia for a minimum of one year in recognised training centres.43 Those providing critical care for cardiothoracic surgical patients should have received training as described by the Faculty of Intensive Care Medicine (see Cardiothoracic Critical Care, Guidelines...
Consultant or autonomously practising anaesthetists intending to follow a career in paediatric cardiothoracic anaesthesia should have higher training in general paediatric anaesthesia of at least one year followed by a specialist training period of an appropriate duration in the subspecialty.
All staff should have access to adequate time, funding and facilities to undertake and update training that is relevant to their clinical practice, including annual mandatory training such as basic life support.
