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9. List of recommended guidelines
Departments should have written guidelines, setting out local standards of care (based on national
standards where these exist), including as a minimum the following (listed alphabetically):
• Analgesia post-caesarean section (including TAP blocks)
• Antacid prophylaxis for labour and delivery
• Antibiotic and thromboprophylaxis for caesarean section
• Awareness under general anaesthesia
• Cell salvage
• Conditions requiring antenatal referral to the anaesthetist
• Fasting before elective and emergency obstetric procedures
• General anaesthesia for caesarean section
• Guideline development
• HDU admission and discharge criteria
• High BMI (> 40 kg.m -2 )
• Intrauterine fetal resuscitation
• Intravenous opioid PCA (Including remifentanil PCA if available locally)
• Management of major haemorrhage (including trigger phrase to activate major haemorrhage
transfusion protocol)
• Management of pre-eclampsia and eclampsia
• Modified Obstetric Early Warning Score use
• Oral intake during labour
• Provision of information to patients including:
o Anaesthesia for caesarean section (general and regional)
o Pain management in labour
• Regional anaesthesia including:
o Hypotension during regional block
o Management of failed or inadequate regional block
o Management of high regional block
o Management of accidental dural puncture
o Management of epidural haematoma
o Management of post-dural puncture headache
o Management of regional techniques in patients receiving thromboprophylaxis
o Regional blocks for labour analgesia
o Regional blocks for surgery
• Recovery following general and regional anaesthesia
• Resuscitation of the pregnant patient
• Staffing levels
• Skills and drills training.
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