Consent For Anaesthesia Research Articles

Parental knowledge and attitudes toward discussing the risk of death from anesthesia.

There is considerable debate as to the extent of disclosure of risks when obtaining informed consent for anesthesia, especially when discussing with parents the rare risk of death of healthy children about to undergo elective, outpatient surgery. In Part I, we attempted to determine parents' knowledge about the risks of anesthesia as well as their thoughts toward either hearing, or not hearing, about the risk of death. In the first part of our study, 115 parents completed questionnaires before speaking with the anesthesiologist. Ninety-six (87%) wanted to know the chances of death as a result of anesthesia, whereas 14 (13%) did not. Seventy-five (68%) parents knew that this risk was "extremely rare," 21 (19%) believed that it occurs "once in a while," and 14 (13%) thought there was "no chance." Eighty-two (74%) parents wanted to know "all possible risks," 26 (24%) wanted to know only "those that are likely to occur," and 3 (2%) wanted to know only about those that would "result in significant injury." Mothers were more likely to want to hear all possible risks, whereas fathers were more likely to want to know only about those that are likely to occur (P = 0.001). Otherwise, responses were not influenced by the sex of the parents, the age of the child, or whether the child or any siblings had had surgery in the past. In Part II, a separate group of 121 parents were surveyed after participating in the preanesthetic discussion with the anesthesiologist.(ABSTRACT TRUNCATED AT 250 WORDS)

A risk-specific anesthesia consent form may hinder the informed consent process

A risk-specific anesthesia consent form may hinder the informed consent process

A risk-specific anesthesia consent form may hinder the informed consent process

Study Objective: To evaluate the effect of a preprinted, risk-specific consent form on the amount of anesthetic risk information patients retain from the preoperative interview. Design: Postoperative survey of consecutive inpatients to determine risk information retained before and after implementation of a preprinted anesthesia consent form, using standard preoperative risk discussions. Setting: Inpatient units of a university medical center. Patients: Two groups of patients, both of whom received a standard oral discussion of anesthetic risk information, were compared. Patients in the control group (125 consecutive inpatients) received this information only orally and were interviewed two weeks prior to implementation of a preprinted anesthesia consent form. Patients in the study group (92 consecutive inpatients) received this information orally and via a preprinted consent form and were interviewed between the fourth and sixth weeks after implementation of a preprinted anesthesia consent form. Interventions: Anesthesia residents discussed five standard anesthetic risks with elective, adult inpatients (n = 233) during a two-week period immediately before and between the fourth and sixth weeks after instituting the mandatory use of a risk-specific anesthesia consent form. These patients were interviewed postoperatively by one of the authors to determine the amount of anesthesia risk information they retained. Measurements and Main Results: Results of the postoperative survey showed that patients in the control group retained more information concerning anesthetic risks than did those in the study group (33% vs 19%, p < 0.01). Conclusions: to improve the informed consent process, either a better method of presenting the preprinted, risk-specific consent form or another method of simultaneously conveying and documenting risk information is needed.

Legal View of Informed Consent for Anesthesia During Labor

Legal View of Informed Consent for Anesthesia During Labor

Legal View of Informed Consent for Anesthesia during Labor

Legal View of Informed Consent for Anesthesia during Labor

Evaluation of Informed Consent for Anesthesia for Labor and Delivery

Evaluation of Informed Consent for Anesthesia for Labor and Delivery

Obtaining and Documenting Informed Consent for Anesthesia in University Hospitals

Obtaining and Documenting Informed Consent for Anesthesia in University Hospitals

Clinical Evaluation of the Patients with Anesthesia Consent

Clinical Evaluation of the Patients with Anesthesia Consent

A SINGLE-SHEET COMBINED ANAESTHETIC RECORD AND CONSENT FORM

A SINGLE-SHEET COMBINED ANAESTHETIC RECORD AND CONSENT FORM

After Hemorrhoidectomy

ALTHOUGH HEMORRHOIDS are usually not a serious problem, they frequently cause a great deal of concern and discomfort to a patient. The most common symptoms are: rectal bleeding, pain on defecation, constipation, pruritus, staining, and prolapse of the internal hemorrhoids. A patient may complain of one or a combination of these symptoms. Following admission to our 12-bed section reserved for proctological problems at the Veterans Administration Hospital, the patient is usually prepared for a proctosigmoidoscopic examination. Of course, if he has severe rectal bleeding, the physician is summoned before any sort of preparation is begun since emergency surgery may be necessary to control the bleeding. Reassurance is important to the patient admitted with bleeding hemorrhoids because he is apt to be frightened and apprehensive. Strong oral laxatives are not necessary prior to the proctosigmoidoscopy since diarrhea frequently ensues, and the rectum that has been cleared by this means soon fills with loose stool. Soapsuds enemas cause anal burning and the passage of mucus, thus giving the bowel a reddened and inflamed look. For these reasons, one to three plain warm water or normal saline enemas are administered until clear about two hours prior to the examination. The enemas should be given gently to prevent trauma and pain to the already uncomfortable patient. Following this preparation an inspection is made of the lower sigmoid colon to rule out the possibility of polyps or a malignant lesion giving rise to rectal bleeding. Prior to surgery the patient has a complete physical evaluation. This includes a thorough history and physical examination, chest x-ray, complete blood count, serology, urinalysis, and an electrocardiogram if he is over 40 years of age. If his hemoglobin is under 9 Gm., he is transfused before surgery. The day before surgery the rectal area is shaved. Also the day before surgery and the following morning the nurse charts the patient's blood pressure two times, one hour apart, for the anesthetist's information. The patient signs the operative consent for spinal anesthesia, at which time the nurse instructs him about his postoperative care and the routine he will be expected to follow.

After Hemorrhoidectomy: Postoperative Nursing Care

ALTHOUGH HEMORRHOIDS are usually not a serious problem, they frequently cause a great deal of concern and discomfort to a patient. The most common symptoms are: rectal bleeding, pain on defecation, constipation, pruritus, staining, and prolapse of the internal hemorrhoids. A patient may complain of one or a combination of these symptoms. Following admission to our 12-bed section reserved for proctological problems at the Veterans Administration Hospital, the patient is usually prepared for a proctosigmoidoscopic examination. Of course, if he has severe rectal bleeding, the physician is summoned before any sort of preparation is begun since emergency surgery may be necessary to control the bleeding. Reassurance is important to the patient admitted with bleeding hemorrhoids because he is apt to be frightened and apprehensive. Strong oral laxatives are not necessary prior to the proctosigmoidoscopy since diarrhea frequently ensues, and the rectum that has been cleared by this means soon fills with loose stool. Soapsuds enemas cause anal burning and the passage of mucus, thus giving the bowel a reddened and inflamed look. For these reasons, one to three plain warm water or normal saline enemas are administered until clear about two hours prior to the examination. The enemas should be given gently to prevent trauma and pain to the already uncomfortable patient. Following this preparation an inspection is made of the lower sigmoid colon to rule out the possibility of polyps or a malignant lesion giving rise to rectal bleeding. Prior to surgery the patient has a complete physical evaluation. This includes a thorough history and physical examination, chest x-ray, complete blood count, serology, urinalysis, and an electrocardiogram if he is over 40 years of age. If his hemoglobin is under 9 Gm., he is transfused before surgery. The day before surgery the rectal area is shaved. Also the day before surgery and the following morning the nurse charts the patient's blood pressure two times, one hour apart, for the anesthetist's information. The patient signs the operative consent for spinal anesthesia, at which time the nurse instructs him about his postoperative care and the routine he will be expected to follow.