OSCE Test with all Correct & 100% Verified Answer |
Guaranteed To Pass |Latest Version
1. TREATMENT
Knock on door
OP-TIONS AND
WASH HANDS
IN-FORMED
"Hi, my name is Dr. Hwang and I am the anesthesiologist taking care of
CON-SENT
you today"
Use names!!
Must address concerns, explain indications, benefits, risks and how to
minimize them, alternative options, elicit question and confirm final
decision
Themes: labor consent, canceling cases, minor refusal, coercion, informed
2. 1) Consent for
refusal
labor epidural -
discuss I'm here to discuss the epidural you requested for labor pain control. I
indication, will be going over the benefits, risks, and alternative options. Do you
benefits, and have any urgent questions before I share these information with
risks you?
When placing the epidural, you will be awake but in a comfortably seated
position and we will be communicating constantly. I will give you a
numbing medication in the middle of low back, where epidural needle
will be inserted and advanced to an area just outside the compartment
where the spinal cord and nerves float in fluid called cerebral spinal
fluid. A small flexible medication tubing will be left in that area to
continuously deliver numbing and pain medication to help with labor
pain.
Benefits: superior pain control, can be used for urgent or emergent c
section and still keep you awake
Risks: commonly low blood pressure, n/v -- both of which are
transient and minimized by fluids; less commonly is advancement
further into the cerebral fluid space called "Dural puncture" which
, OSCE Test with all Correct & 100% Verified Answer |
Guaranteed To Pass |Latest Version
can cause headache,
which is often self limited
and managed with rest
and meds; very rare
complications include
bleeding, nerve injury or
paralysis, and loss of
consciousness and
breathing.
Alternatives to epidural
include IV opioid pain
medication, regional blocks
which
, OSCE Test with all Correct & 100% Verified Answer |
Guaranteed To Pass |Latest Version
entail injection of numbing medication at specific nerve sites, and non-
pharma-cologic options such as hypnosis, warm or cold packs. In my
experience, these alternatives are less ettective at pain control but they
can certainly be used.
I know that was a lot of information. What questions do you have for
me? After answering question: Would you like to proceed with
3. Can the mom
give consent epidural?
for epidural if
she re-ceived As long as the patient is not overly narcotized, adequate treatment of
distracting
IV opioids?
labor pain is actually important for consent.
4. Mom is in a lot
of pain and
nurse wants
Validate the concerns, but to the best of my abilities, even in presence
you to pro-ceed
of signifi-cant labor pain, informed consent should be obtained and is
with epidural
important for patient safely.
without
consent. *Only in emergent situation where life of mother or baby is at risk, it is
What would acceptable to proceed without informed consent.
you say?
5. 2) Canceling a
Actually, that is something I would like to discuss with you. Upon
case in
evaluating (name), I believe that proceeding with anesthesia today
pediatric case
would place (name) at an unacceptable amount of risk. He appears to
due to URI
have a significant cold, which increases his risk of lung complications,
- mother asks
such as very tight airways called bron-chospasm or obstruction of
how soon her
breathing called laryngospasm, just to name a few. I recommend we
son will
delay the surgery for 6-8 weeks following resolution of (name)'s cold,
proceed to
let his lungs recover and make it safer for him to have his tonsils
surgery
removed.
, OSCE Test with all Correct & 100% Verified Answer |
Guaranteed To Pass |Latest Version
If mom continues to resist:
- I understand it is
extremely inconvenient to
delay his surgery, especially
when it attects your work
schedule. However, based on
your son's symptoms, his
cold is serious enough that
it places at significant risk
for harm.
Guaranteed To Pass |Latest Version
1. TREATMENT
Knock on door
OP-TIONS AND
WASH HANDS
IN-FORMED
"Hi, my name is Dr. Hwang and I am the anesthesiologist taking care of
CON-SENT
you today"
Use names!!
Must address concerns, explain indications, benefits, risks and how to
minimize them, alternative options, elicit question and confirm final
decision
Themes: labor consent, canceling cases, minor refusal, coercion, informed
2. 1) Consent for
refusal
labor epidural -
discuss I'm here to discuss the epidural you requested for labor pain control. I
indication, will be going over the benefits, risks, and alternative options. Do you
benefits, and have any urgent questions before I share these information with
risks you?
When placing the epidural, you will be awake but in a comfortably seated
position and we will be communicating constantly. I will give you a
numbing medication in the middle of low back, where epidural needle
will be inserted and advanced to an area just outside the compartment
where the spinal cord and nerves float in fluid called cerebral spinal
fluid. A small flexible medication tubing will be left in that area to
continuously deliver numbing and pain medication to help with labor
pain.
Benefits: superior pain control, can be used for urgent or emergent c
section and still keep you awake
Risks: commonly low blood pressure, n/v -- both of which are
transient and minimized by fluids; less commonly is advancement
further into the cerebral fluid space called "Dural puncture" which
, OSCE Test with all Correct & 100% Verified Answer |
Guaranteed To Pass |Latest Version
can cause headache,
which is often self limited
and managed with rest
and meds; very rare
complications include
bleeding, nerve injury or
paralysis, and loss of
consciousness and
breathing.
Alternatives to epidural
include IV opioid pain
medication, regional blocks
which
, OSCE Test with all Correct & 100% Verified Answer |
Guaranteed To Pass |Latest Version
entail injection of numbing medication at specific nerve sites, and non-
pharma-cologic options such as hypnosis, warm or cold packs. In my
experience, these alternatives are less ettective at pain control but they
can certainly be used.
I know that was a lot of information. What questions do you have for
me? After answering question: Would you like to proceed with
3. Can the mom
give consent epidural?
for epidural if
she re-ceived As long as the patient is not overly narcotized, adequate treatment of
distracting
IV opioids?
labor pain is actually important for consent.
4. Mom is in a lot
of pain and
nurse wants
Validate the concerns, but to the best of my abilities, even in presence
you to pro-ceed
of signifi-cant labor pain, informed consent should be obtained and is
with epidural
important for patient safely.
without
consent. *Only in emergent situation where life of mother or baby is at risk, it is
What would acceptable to proceed without informed consent.
you say?
5. 2) Canceling a
Actually, that is something I would like to discuss with you. Upon
case in
evaluating (name), I believe that proceeding with anesthesia today
pediatric case
would place (name) at an unacceptable amount of risk. He appears to
due to URI
have a significant cold, which increases his risk of lung complications,
- mother asks
such as very tight airways called bron-chospasm or obstruction of
how soon her
breathing called laryngospasm, just to name a few. I recommend we
son will
delay the surgery for 6-8 weeks following resolution of (name)'s cold,
proceed to
let his lungs recover and make it safer for him to have his tonsils
surgery
removed.
, OSCE Test with all Correct & 100% Verified Answer |
Guaranteed To Pass |Latest Version
If mom continues to resist:
- I understand it is
extremely inconvenient to
delay his surgery, especially
when it attects your work
schedule. However, based on
your son's symptoms, his
cold is serious enough that
it places at significant risk
for harm.
