consent and pre-procedure set-up?

Question 1

what is consent?

Answer 1

• 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

Question 2

3 levels of consent?

Answer 2

1. informed
2. simple
3. inadequate consent (ignorant consent)

Question 3

what is informed consent?

Answer 3

• a competent patient voluntarily acceps a plan for medical care after the physician adequatly discloses the proposed plan, its risks, and benifits

Question 4

3 forms of informed consent?

Answer 4

1. voluntary
2. informed
3. capacity

Question 5

what is informed consent- voluntary?

Answer 5

• 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

Question 6

what is informed consent- informed?

Answer 6

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

Question 7

what is informed consent- capacity?

Answer 7

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

Question 8

patient can express their consent by? (2)

Answer 8

• written consent

- oral consent

Question 9

what is writen consent?

Answer 9

Mandatory in every invasive diagnostic/therapeutic procedures. Should be in patient’s own language/ have translator if English is not their first language

Question 10

what is oral consent?

Answer 10

Needed in tests such as putting in stitches or radiological examination (especially involving female patients)

Question 11

what is simple consent?

Answer 11

Obtaining a patient’s permission to perform a procedure, without knowledge of that procedure

Question 12

2 forms of simple consent?

Answer 12

1. expressed

2. implied

Question 13

what is expressed consent (simple consent)?

Answer 13

occurs when the patient does not stop the procedure from taking place

Question 14

what is implied consent (simple consent)?

Answer 14

occurs in emergency situations when it is not possible to obtain consent

Question 15

what in inadequate (ignorant) consent?

Answer 15

This occurs when the patient has not been informed adequately to make a responsible decision

Question 16

what is a catheter?

Answer 16

• tubes of varying lengths and inside diameters with holes in each end that allow the flow of fluids

Question 17

catheters are manufactured out of? (3)

Answer 17

1. teflon
2. polyurethane
3. polyethylene

Question 18

all catheres are disposible T or F?

Answer 18

true

Question 19

who is the choice of catheter for specific procedure made by?

Answer 19

• physician performing the procedure

Question 20

what is the sonographer responsible for- catheters?

Answer 20

• ordering and maintenance of the materials used during procedures including the catheters

Question 21

advantages of teflon catheters? (5)

Answer 21

• good memory-retains shape
• high material strength
• stiffer than other materials
• larger inner diameter
• higher potential to kink

Question 22

advantages of polyurethane catheters? (7)

Answer 22

• high tissue compatibility
• increased lumen diameters
• increased flow rate
• low thrombogenicity
• ease of insertion and placement
• gas sterilized only
• low incidence of tissue trauma

Question 23

advantages of polyethylene catheters? (3)

Answer 23

• high tissue compatibility
• contains no additives soft and flexible
• better torque than polyerethane

Question 24

what are catheter sizes expressed in?

Answer 24

• inches
• millimeters
• french number

Question 25

french gauge system aka? (3)

Answer 25

• french scale
• french number
• FR

Question 26

who is the french gauge system devised by?

Answer 26

• joseph-frederic-benoit charriere
• 19th century parisian
• maker of surgical instruments
• defined the diameter times 3 relationship

Question 27

what is the french gauge system used to measure?

Answer 27

• the size (diameter) of a catheter

* does not measure circumference

Question 28

1 Fr=
mm=
Fr=

Answer 28

1 Fr= 0.33mm

mm= Fr/3

Fr= D (mm) x 3

Question 29

some companies imprint sizing information of the?

Answer 29

hub

Question 30

what is the hub?

Answer 30

• the proximal portion of the catherer that provides an attachment for the syringe

Question 31

the distal end of a catheter is what shape?

Answer 31

• straight or shaped

Question 32

what does the shape of a catheter depend on?

Answer 32

• type of procedure being done

- anatomic part being imaged

Question 33

function of cateters containing a small balloon?

Answer 33

• mechanically occlude vessels
• allow hemodynamic studies to be performed
• provide hemorrhage control and segmental isolation

Question 34

needles are measured according to what system?

Answer 34

Stubs needle gauge system

Question 35

what is the stubs needle gauge system derived from?

Answer 35

stubs iron wire gauge system

• developed in the early 19th century england

Question 36

what is the stubs needle gauge system?

Answer 36

• used to describe sizes of different needles

Question 37

what does the gauge number describe?

Answer 37

• the outer diameter of the needle

Question 38

the smaller the gauge number the?

Answer 38

larger the outer diameter

Question 39

intramuscular injections gauge number?

• adults
• children

Answer 39

adults: 21-23 gauge
children: 25-27 gauge

Question 40

subcutaneous injections guage number?

Answer 40

25-27 gauge for both adults and children

• some newer medications for diabetes recomment using 30-31 gauge

Question 41

what is a universal protocol?

Answer 41

• created to prevent wrong patient, wrong procedure, wrong surgical site

Question 42

3 steps of universal protocol?

Answer 42

1. pre-prodedure verification
2. marking the procedure site
3. a time out (final verification) AKA pause

Question 43

pre-prodedure verification process ensures what?

Answer 43

• that all documents are available prior to the start of procedure
• missing info must be addressed before the start of procedure

Question 44

patient verification includes (3)?

Answer 44

• patient identification with 2 identifiers ( name, medical record number, DOB)
• history and physical in the medical record
• signed consent with correct procedure verified

Question 45

sonographers role in pre-procedural set up? (6)

Answer 45

• evaluation of medical records
• lab values
• allergies
• other imaging studies
• informed consent
• set up sterile biopsy tray

Question 46

marking the procedure site is done by?

Answer 46

• marked by a licensed independent practitioner who is accountable for the procedure and is present when procedure is performed

Question 47

marking of procedure site may be delegated to? (4)

Answer 47

• medical residents
• fellows
• physician
• assistants
• advanced practice registered nursed

Question 48

what is a time out?

Answer 48

• deliberate pause in activity involving clear communication among all members of surgical/procedural team

Question 49

time out included verifying? (5)

Answer 49

• correct patient identity
• correct procedure verified with consent
• correct site or side
• allergies
• availability of correct implants and any special equipment or requirements

Question 50

Post procedure?

Answer 50

• 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