After major thoracic surgery, patients should be transferred to an appropriately sized, equipped and staffed post-anaesthetic recovery area. Planned or emergency access to ICU or HDU should be available.31
Non-invasive ventilation facilities should be available in the immediate postoperative period, for example bilevel positive airway pressure (BiPAP), continuous positive airway pressure (CPAP) and high-flow nasal oxygen therapy (HFNO).32
Access to theatres and associated clinical areas should be appropriately restricted.7
Where possible, point of care or near-patient testing should be used for blood gas analysis, measurement of electrolytes and blood sugar, haemoglobin and coagulation. This might include platelet mapping, thromboelastography or thromboelastometry.35
Immediate access to expert haematology advice, haematology laboratory services and blood products should be available.
There should be immediate access to expert radiology advice, x-ray facilities and computerised axial tomography services for patients undergoing cardiac or thoracic surgery.
Access to measurements of respiratory function should be available for patients undergoing cardiac or thoracic surgery, including a facility for cardiopulmonary exercise testing.
Physiotherapy services should be available during the preoperative preparation and postoperative care of patients undergoing cardiac or thoracic surgery.
All anaesthetic equipment should be checked before use in accordance with the Association of Anaesthetists published guidelines. Anaesthetic machine checks should be recorded in a log and on the anaesthetic chart.36
