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Guidelines and commonly used algorithms for paediatric emergencies should be readily available and regularly rehearsed.²⁰¹

Guidelines for fluid management specific to children, and equipment for accurate fluid delivery, should be available.²²²

Pain assessment tools used should differ, depending on the age and ability of the child. Self-reporting tools should be used where possible, with behavioural or composite tools for those unable to self-report.^223,224

Protocols for the use of epidural infusions, morphine infusions, patient controlled analgesia infusions and nerve catheter local anaesthesia infusions should be available and specific for children.^223,224

A policy should be in place for the management of non-peripartum pregnant women. This should detail the involvement of the multidisciplinary obstetric team, including midwives, neonatologists and obstetricians, depending on gestational stage.²²⁶

A policy should be in place for the perioperative care of breastfeeding mothers. This should include guidance to staff on the requirements to facilitate breastfeeding, anaesthesia protocols for breastfeeding mothers, outline supportive measures and provide clear instructions for the patient pre and post anaesthesia or sedation.²²⁷

Multidisciplinary care improves outcomes. Protocol driven integrated pathways guide care effectively, but should be individualised to suit each patient, with emphasis on management of postoperative pain and avoidance of postoperative delirium.^{233,234,235, 238, 239}

Preoperative assessment, optimisation and shared decision making in patients with multiple comorbidities, frailty or cognitive impairment require a cross specialty approach involving anaesthetists, surgeons, geriatricians, pharmacists and allied health professionals. Liaison with a clinical pharmacist in the perioperative period will enable optimisation of medicines and improved management of the patients’ non-surgical comorbidities during this time. The development of such teams...

Care of the frail and older surgical patient starts at the contemplation of surgery and continues through the hospital stay and beyond. Models of care for frail and older patients should include multidisciplinary management between surgical teams, physicians with expertise in the assessment and management of frailty/delirium and allied health professionals providing consistent hands-on medical care, direction of rehabilitation goal...

Models of care could include comprehensive geriatric assessment which may have potential to improve outcomes.²⁴²