Specialist on-call rotas >> Anaesthetic on-call rotas for vascular surgery

Anaesthetic on-call rotas for vascular surgery were very uncommon. Only 3% (5/178) of hospitals responded that they had a vascular anaesthetic rota. It appears to be accepted practice that whilst individual anaesthetists will develop expertise in anaesthesia for elective vascular surgery, any anaesthetist should be prepared to anaesthetise a patient for surgery for an emergency AAA repair. This seems illogical. The NCEPOD advisors commented that now that anaesthetic training has been shortened, new anaesthetic consultants may have seen very few operations for ruptured aortic aneurysm before appointment. It is not possible from the data collected for this study to make any observation as to whether better outcome for emergency AAA surgery is associated with the presence of a vascular anaesthetic rota. However, is it not time for at least large vascular units to implement vascular anaesthetic on-call rotas so that the sickest vascular patients are cared for by the most experienced practitioners?