Chapter 5: Guidelines for the Provision of Emergency Anaesthesia Services 2024
Departments should develop and regularly review burn and plastic surgery referral guidelines and major incident plans.53
Departments should develop and regularly review burn and plastic surgery referral guidelines and major incident plans.53
Agreed local clinical guidelines should be in use, produced by an appropriately constituted multiprofessional team, comprising anaesthetists, specialist nurses, surgeons, critical care clinicians, pharmacists, specialty consultants and managers. These guidelines should cover at least the following:
Each unit should have a designated clinical lead (see glossary) anaesthetist who is responsible for cardiac anaesthesia services. This should be recognised in their job plan and they should be involved in multidisciplinary service planning and governance within the unit.
An appropriately trained consultant cardiac anaesthetist should be available at all times, through a formal on-call rota.4
Trained staff and appropriate facilities should be immediately available for emergency resternotomy and bypass. A suitably trained resident anaesthetist should be immediately available for emergencies.5
Appropriate local arrangements should be made for the care of postoperative surgical patients being managed outside the main cardiothoracic intensive care unit (ICU), for example postoperative recovery areas and wards.6
Interventional cardiology services increasingly require anaesthesia, critical care and nursing resources depending on procedural complexity and patient morbidity. General anaesthesia may be needed to facilitate complex interventions or required in an emergency for invasive cardiological procedures. Both eventualities require that appropriate anaesthetic staffing, skilled assistance, equipment and monitoring should be available.2
At centres where 24/7 primary percutaneous coronary interventions are performed, and in designated heart attack centres, which include out of hospital cardiac arrest patients, there should be provision for immediate availability of a resident anaesthetist, skilled assistance and appropriate equipment and facilities.
All anaesthetists and anaesthetic assistants should receive systematic training in the use of new equipment. This should be documented.33