consent and pre-procedure set-up? Flashcards
what is consent?
- a contract where the patient voluntarily gives permission to perform a service
- patient must be informed of all aspects of procedure prior to signing a consent
- double check to make sure consent is signed prior to exam
3 levels of consent?
- informed
- simple
- inadequate consent (ignorant consent)
what is informed consent?
- a competent patient voluntarily acceps a plan for medical care after the physician adequatly discloses the proposed plan, its risks, and benifits
3 forms of informed consent?
- voluntary
- informed
- capacity
what is informed consent- voluntary?
- the decision to either consent or not to consent to treatment must be made by the person themselves, and must not be influenced by pressure from medical staff, friends or family
what is informed consent- informed?
person must be given all of the information, by the person who will perform the procedure, in terms of what the treatment involves, including the benefits and risks, whether there are reasonable alternative treatments and what will happen if treatment does not go ahead
what is informed consent- capacity?
the person must be capable of giving consent, which means they understand the information given to them, and they can use it to make an informed decision
patient can express their consent by? (2)
- written consent
- oral consent
what is writen consent?
Mandatory in every invasive diagnostic/therapeutic procedures. Should be in patient’s own language/ have translator if English is not their first language
what is oral consent?
Needed in tests such as putting in stitches or radiological examination (especially involving female patients)
what is simple consent?
Obtaining a patient’s permission to perform a procedure, without knowledge of that procedure
2 forms of simple consent?
- expressed
2. implied
what is expressed consent (simple consent)?
occurs when the patient does not stop the procedure from taking place
what is implied consent (simple consent)?
occurs in emergency situations when it is not possible to obtain consent
what in inadequate (ignorant) consent?
This occurs when the patient has not been informed adequately to make a responsible decision
what is a catheter?
- tubes of varying lengths and inside diameters with holes in each end that allow the flow of fluids
catheters are manufactured out of? (3)
- teflon
- polyurethane
- polyethylene
all catheres are disposible T or F?
true
who is the choice of catheter for specific procedure made by?
- physician performing the procedure
what is the sonographer responsible for- catheters?
- ordering and maintenance of the materials used during procedures including the catheters
advantages of teflon catheters? (5)
- good memory-retains shape
- high material strength
- stiffer than other materials
- larger inner diameter
- higher potential to kink
advantages of polyurethane catheters? (7)
- high tissue compatibility
- increased lumen diameters
- increased flow rate
- low thrombogenicity
- ease of insertion and placement
- gas sterilized only
- low incidence of tissue trauma
advantages of polyethylene catheters? (3)
- high tissue compatibility
- contains no additives soft and flexible
- better torque than polyerethane
what are catheter sizes expressed in?
- inches
- millimeters
- french number
french gauge system aka? (3)
- french scale
- french number
- FR
who is the french gauge system devised by?
- joseph-frederic-benoit charriere
- 19th century parisian
- maker of surgical instruments
- defined the diameter times 3 relationship
what is the french gauge system used to measure?
- the size (diameter) of a catheter
* does not measure circumference
1 Fr=
mm=
Fr=
1 Fr= 0.33mm
mm= Fr/3
Fr= D (mm) x 3
some companies imprint sizing information of the?
hub
what is the hub?
- the proximal portion of the catherer that provides an attachment for the syringe
the distal end of a catheter is what shape?
- straight or shaped
what does the shape of a catheter depend on?
- type of procedure being done
- anatomic part being imaged
function of cateters containing a small balloon?
- mechanically occlude vessels
- allow hemodynamic studies to be performed
- provide hemorrhage control and segmental isolation
needles are measured according to what system?
Stubs needle gauge system
what is the stubs needle gauge system derived from?
stubs iron wire gauge system
- developed in the early 19th century england
what is the stubs needle gauge system?
- used to describe sizes of different needles
what does the gauge number describe?
- the outer diameter of the needle
the smaller the gauge number the?
larger the outer diameter
intramuscular injections gauge number?
- adults
- children
adults: 21-23 gauge
children: 25-27 gauge
subcutaneous injections guage number?
25-27 gauge for both adults and children
- some newer medications for diabetes recomment using 30-31 gauge
what is a universal protocol?
- created to prevent wrong patient, wrong procedure, wrong surgical site
3 steps of universal protocol?
- pre-prodedure verification
- marking the procedure site
- a time out (final verification) AKA pause
pre-prodedure verification process ensures what?
- that all documents are available prior to the start of procedure
- missing info must be addressed before the start of procedure
patient verification includes (3)?
- patient identification with 2 identifiers ( name, medical record number, DOB)
- history and physical in the medical record
- signed consent with correct procedure verified
sonographers role in pre-procedural set up? (6)
- evaluation of medical records
- lab values
- allergies
- other imaging studies
- informed consent
- set up sterile biopsy tray
marking the procedure site is done by?
- marked by a licensed independent practitioner who is accountable for the procedure and is present when procedure is performed
marking of procedure site may be delegated to? (4)
- medical residents
- fellows
- physician
- assistants
- advanced practice registered nursed
what is a time out?
- deliberate pause in activity involving clear communication among all members of surgical/procedural team
time out included verifying? (5)
- correct patient identity
- correct procedure verified with consent
- correct site or side
- allergies
- availability of correct implants and any special equipment or requirements
Post procedure?
- BP
- clean up
- proper disbursement of samples into tubes/contariners to send to lab
- doctor signing of requisitions for labs
- pressure dressing or baindaid
- patient well-being and follow up questions
