Mori Dr Benjamin Filipopoulos 26 th March 2020 Learning objectives To revise the definition of Consent Gain an appreciation for expected practice around Consent Appreciate when a patient is competent to give Consent ID: 1032175
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1. Informed ConsentMr Krinal MoriDr Benjamin Filipopoulos26th March 2020
2. Learning objectivesTo revise the definition of ConsentGain an appreciation for expected practice around ConsentAppreciate when a patient is competent to give ConsentEvaluations:i-phone – just point cameraAndroid – use QR reader appOr use this link: https://forms.gle/Xzd7esuBnFu8vtj39
3. Definition and Good Medical PracticeThe process of information exchange between patient and surgeon to ensure understanding of condition and any proposed surgical treatment.Ensure informed consent has been obtained from the patient (or substitute decision-maker) before undertaking elective operations or procedures and whenever possible in an emergency (RACS Code of Conduct)Ensure provision of information to patients in a way that they can understand, BEFORE asking for their consent (Good Medical Practice)
4. RequirementsCompetenceAppropriate language/interpretation servicesBe aware yourself of the procedure, how it is performed, and material risks
5. Content of DiscussionNature of condition being treatedProcedure detailsExpected benefitsCommon and material risks and treatment of complicationsRequired, conventional, experimental?Other treatment options (where appropriate)Operator/proceduralist
6. Anthony and the Awful Abscess 25M presenting with right perianal abscessConstruction workerSmokerNil other PHxBooked for EUA & Incision & Drainage of right perianal abscess +/- Insertion of Seton
7. Risks and ConsiderationsRisks:BleedingInfectionNeurovascular injuryRecurrenceSphincter injuryDelayed healingRepeat or further procedurePainConsiderations:CompetentAdult
8. Johnny and the Angry Appendix 15M presenting with acute appendicitisBrought into hospital by fatherNil other PHxDecision made for Laparoscopic appendicectomy +/- conversion to open
9. Risks and ConsiderationsRisks:BleedingInfectionNeurovascular injuryBowel, liver or other organ injuryConversion to openStump leakFurther procedurePainConsiderations:Minor – unable to consentPatient to be involved in consent process and be empoweredConsent to be gained and signed by father
10. Myrtle and the Obstructing Sigmoid Adenocarcinoma 82F presenting with large bowel obstructionPHx: AF (on warfarin), HTN, dyslipidaemia, bilateral inguinal hernia repairsFrom home alone; I-ADLs; attends regular community exercise sessions and volunteers in charity groupsAlone in hospital, son currently driving inDecision made for Laparotomy + sigmoid colectomy +/- stoma formation +/- proceed
11. Risks and ConsiderationsRisks:BleedingInfectionNeurovascular injuryBowel, liver or other organ injuryAnastomotic leakFurther procedureAnaesthetic risksPerioperative morbidity and mortality*PainThromboembolic risk*Considerations:Confirm competence and not deliriousVulnerable patient and major surgery – MEPOA/NOK to be involved in consent processEnsure patient and MEPOA/NOK are aware of situation – other relatives to visitEnsure patient and family aware of likely ICU admissionBlood transfusion consent
12. Key pointsBe able to assess competenceUnderstand the procedure for which you are consenting, the risks involved and how complications are generally managedRefer to senior when unsure, and especially proceduralist themselves
13. Thank you!Please complete the evaluation:i-phone* – just point cameraAndroid* – point camera / use QR reader app*may require you to switch off TNH WifiOr use this link: https://forms.gle/Xzd7esuBnFu8vtj39
14. Learning standardsThis presentation addresses the following components of the Australian Curriculum Framework for Junior Doctors:[component 1][component 2][component 3]This presentation is aligned with the following NSQHS Standards:[Standard x][Standard y][Standard z]