Before starting anaesthesia in a cardiac catheterisation laboratory located away from the operating theatre complex, what is the FIRST step in the universal safety checklist for remote-site anaesthesia according to Indian and international practice?

• A Confirm availability of an anaesthesia machine with calibrated vapourisers
• B Verify immediate access to a functioning suction apparatus
• C Ensure reliable oxygen supply and an emergency trolley with defibrillator ✓
• D Check availability of difficult-airway equipment and trained assistance

Explanation

The fundamental requirements for any remote location are a reliable oxygen source, suction, and an anaesthetic machine with monitoring plus an emergency trolley with defibrillator and drugs; oxygen supply is listed first because no other intervention matters without it. Difficult-airway equipment and trained help are essential but follow once basic life-support infrastructure is verified. Suction alone or the machine alone is insufficient as a first check.

Reference: Miller's Anesthesia, 9th ed.

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Written and medically reviewed by the StethoPrep medical team.