Chapter 19: Guidelines on the Provision of Anaesthesia Services for Thoracic Procedures 2025
There should be a forum for discussion of matters relevant to both surgeons and anaesthetists, for example protocol development and critical incidents.
There should be a forum for discussion of matters relevant to both surgeons and anaesthetists, for example protocol development and critical incidents.
Anaesthetists should demonstrate engagement with ongoing education and CPD as required.74
Departments should facilitate the collection of data required for anaesthetists undertaking major vascular cases to keep a personal logbook.
With the expiry of its original patent last year, high cost is no longer a factor prohibiting its use, which will invariably further increase. In this article, we seek to highlight the resulting increased potential for contraceptive failure and propose methods to better inform and protect patients.
Due to its ability to encapsulate progesterone – present in contraceptive pills, vaginal rings, implants and intra-uterine devices – the administration of sugammadex may reduce their biological effect and cause contraceptive failure. This was identified in in-vitro studies, using isothermal microcalorimetry, performed as part of the drug’s development. While in-vivo studies to quantify the reduction in serum progesterone concentration following sugammadex administration have not been performed, these results have shaped current manufacturer guidance.
To act as duty anaesthetist without direct supervision from a consultant, the anaesthetist should meet the basic training specifications and have attained the RCoA’s Initial Assessment of Competency in Obstetric Anaesthesia.22
At all times, there should be an on site anaesthetist who has the ability and training to undertake immediate clinical care of all emergency surgical patients. Explicit arrangements should be in place to provide support from additional anaesthetists appropriate to local circumstances.
Anaesthesia departments should have a nominated anaesthetist immediately available and free from direct clinical responsibilities to provide cover in clinical emergencies, as well as providing advice and support to other anaesthetists.39
The anaesthetist should not be responsible for performing the cardioversion; an appropriately trained physician, cardiologist or supervised nurse specialist is responsible for this role. Wherever possible, the anaesthetic should be administered by an appropriately experienced anaesthetist.33