Minimum Facilities for Safe Administration of Anaesthesia

Provision of safe anaesthesia requires appropriate:

Staff

Requires:

  • A dedicated assistant for the anaesthetist
  • Assistance for positioning
  • Technical assistance for functioning and servicing of equipment

Facilities

Should have: A place for recovery from anaesthesia * Contingency plans for safe emergency evacuation from the operating suite or recovery areas

Delivery Suites

Must have:

  • Midwives competent in obstetric epidural management, if used
  • A minimum FiO2 of 0.3 if inhalational analgesia used
  • Exclusive anaesthetic suction
  • Separate oxygen outlets for mother and neonate
  • Neonatal resuscitation equipment

Electroconvulsive Therapy Locations

Must have:

  • Breathing system capable of 100% oxygen
  • Alternative breathing system
  • Adequate oxygen reserves

Dental Surgery

Must have:

  • Dental chair allowing patient to be rapidly placed horizontally or head-down

Imaging

Must have:

  • Monitoring equipment complying with ANZCA standards
  • Consideration of location for anaesthetic delivery systems

Equipment:

Essential requirements:

  • Specialist anaesthetist to advice on equipment choice and maintenance
  • Nursing or technical staff to organise cleaning, maintenance, and servicing of equipment

In each anaesthetising location there must be:

  • Gas and anaesthetic delivery:
    • Device to deliver accurately measured flow of air and oxygen
    • Calibrated vaporisers
      When required.
    • Infusion devices for controlled delivery of IV anaesthesia
      When required.
    • Range of suitable breathing systems
    • Separate means to inflate lungs with oxygen
    • Scavenging
      If anaesthetic gases and vaporisers.
  • Safety equipment
    • Gowns
    • Gloves
    • Masks
    • Eye shields
  • Monitoring
    • Stethoscope
    • Sphygmomanometer
    • Standard ANZCA monitoring
  • Airway equipment
    Including a range of:
    • Face masks
    • OPAs
    • NPAs
    • Laryngoscopes and blades
    • ETTs and connectors
    • Bougies and stylets
    • Syringes
    • Magill forceps and throat packs
    • Sterile lubricant
  • IV access equipment
    • Tourniquets
    • IV access and infusion equipment
    • Sharps disposal devices

In each anaesthetising location there must be readily available:

  • Difficult intubation equipment
  • Automatic ventilation of the lungs
  • Equipment for measurement of arterial and venous pressures
  • Cardiac defibrillator
  • Pleural drainage sets
  • Telephone or intercom
  • Means to control room temperature
  • Drugs
    To manage:
    • Adrenal dysfunction
    • Anaphylaxis
    • Bronchospasm
    • Cardiac arrest
    • Arrhythmias
    • Coagulopathies
    • Hypoglycaemia
    • Hypotension
    • Pulmonary oedema
    • Raised ICP
    • Respiratory depression
    • Uterine Atony
      If relevant.

Equipment must:

  • Have regular routines for:
    • Checking
    • Cleaning
    • Sterilisation
  • Be serviced appropriately, and have that servicing documented
    Twice a year in absence of a manufacturer recommendation.

References

  1. ANZCA. PS55: Recommendations on Minimum Facilities for Safe Administration of Anaesthesia in Operating Suites and Other Anaesthetising Locations.