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> This is my first list serv post, so I hope it works well!
--> It worked. What a feeling, eh?
> what institutions do about informed consent for abscess drainage
--> In general we consider patients consent by registration to having triage and a doctor and/or nurse see them and take a history and perform an exam and go as far as a normal lay person would be expected to know they'd to in terms of history and exam.
We ask for specific verbal consent or implied consent for any procedures which follow (IV, bloods, LP, suture, injection, providing medication, dressings, etc) before we do them or when we anticipate the need to do them. We do NOT generally document consent if given, but always document any refusals of our recommendations.
Written consent is expected for any procedure during which the patient is likely to be incapacitated to a level where they cannot physically withdraw consent, i.e. anaesthesia/sedation or such. Also, if the procedure is likely to HAVE TO continue once we begin it and if the patient decided to stop it part-way this would not be practical. But if patient is expected to remain fully conscious and communicative, e.g. a procedure under regional anaesthesia, then verbal consent.
So, for example, I will just tell a patient/parent that I am planning to incise and drain an abscess on, say, a thigh. I would be looking a their faces for any evidence of them not wanting this and they can say "no" or ask for further advice and discussion or time to decide. Otherwise, I'd take it that this is what they want. Verbal consent is fine. I will not document it. If I plan to use sedation/GA, then I will then get a consent form and have them sign it. If at any stage they decline the drainage that I think they should accept, I will document their decision and proceed to the next best thing.
Hope this is clear enough.
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