Consent

  • When printing Consents at VUMC, use MedEx (on the virtual machine/desktop)
  • Ensure pt’s signature; Telephone consent requires second physician as witness
  • Use CSN (not the MRN) to locate the pt information for that specific admission or office visit – ensure patient current room number on MedEx screen
  • When consenting pts at NAVA, use the COW with pen pad and the I-Consent program
  • Video guide: https://www.youtube.com/watch?v=6yXOEkFqk2o

 

Lumbar Puncture

  • Common risks: backache (~66%), severe headache
  • Rare risks: spinal hematoma (<0.001%), weakness, numbness, brain function problems, CNS infection, brain herniation

Paracentesis

  • Risks: abdominal wall hematoma (1%), hemoperitoneum, organ puncture, infection

Thoracentesis

  • Common risks (> 5%): coughing, fainting, PTX
  • Rare risks (< 1%): hemothorax, emergency surgery, re-expansion pulmonary edema

Arthrocentesis

  • Common risks: pain during procedure, repeat needle insertion
  • Rare: damage to surrounding vessels, nerves; iatrogenic septic arthritis: (<0.1%)

Dobhoff Tube Placement

  • Common risks: Malpositioned (lung)/coiled tube; perforation anywhere along the tract; cranial placement; aspiration, gastritis, bleeding, vagal response, significant discomfort
  • Contraindications: SBO, ileus; use large bore NGT instead (placed by bedside nurse)

US-Guided PIV Placement

  • Common risks: arterial puncture, nerve irritation/damage during/after procedure, infection, infiltration, thrombus formation