As well as evidence of a thorough preoperative assessment, the anaesthetic chart is used to record preoperative data pertinent to the safe transfer of care between anaesthetists. Importantly, this chart will also serve as a guide to future anaesthetists.
Guidelines published by the Royal College of Anaesthetists outline the requisite dataset to be recorded, although there is no uniformity of anaesthetic chart design throughout the country.
Patient identification details should be included on every anaesthetic chart. As a legal document there must be adequate means of linking the chart to the patient.
The following are the basic identifiers used: 1. Name 2. Date of birth 3. Unique identifying number 4. Gender |