Problems encountered when administering general anaesthetics in accident and emergency departments

Junior anaesthetists in 75 English hospitals were surveyed for their views on whether administering general anaesthetics in A&E departments provoked more anxiety than in the main theatre, and if so what factors contributed to this. Of these anaesthetists, 71% were more apprehensive working in A&E departments than in main theatre; 91% felt that they were adequately experienced but despite this there was a marked decline in apprehension with increasing experience. Sixty eight per cent of the anaesthetists thought that their assistance was inadequate and only 28% had an Operating Department Assistant (ODA). Forty eight per cent said that the equipment was inadequate in either standard or maintenance and 40% said that some of the patients were unsuitable for day case anaesthesia. The authors recommend that anaesthetists performing general anaesthetics in A&E departments should be adequately experienced using equipment provided and maintained by the anaesthetic department and assisted by adequately trained nurses or ODAs.