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All staff working in paediatric recovery should be trained and competent in protocols, and should be familiar with the relevant procedures and personnel if there are safeguarding or child protection concerns that arise while the child is in theatre.²¹⁷

There should be a minimum of one member of the recovery staff, or an anaesthetist with advanced training in paediatric life support on duty. All members of recovery staff should have up-to-date paediatric competencies including resuscitation.²⁰¹

Paediatric equipment to cover all ages should be available in recovery, including a full range of sizes of facemasks, breathing systems, airway adjuncts and tracheal tubes. Essential monitoring equipment includes a full range of paediatric non-invasive blood pressure cuffs and small pulse oximeter probes. Capnography should also be available.²⁰¹

Parents and children should be appropriately educated and equipped with information to address common issues they may face postoperatively, in recovery and on discharge. This information should include leaflets for common procedures highlighting risks and these should be developed locally with support from area networks.²²¹

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