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Signa Vitae

Journal of Anaesthesia, Intensive Care and Emergency Medicine

Informed Consent for Intravenous Contrast Administration in the Emergency Department: Understanding and satisfaction among patients using the video-assisted vs. traditional methods

Abstract

Background. Computed-tomography (CT) is increasingly performed among patients who visit an emergency department (ED), many of whom require the administration of intravenous contrast, to make an accurate diagnosis of their condition and offer prompt treatment. Though the safety profile of new intravenous contrast agents has improved, patients are still exposed to significant risk from potentially life-threatening reactions.

Materials and Methods. This is a prospective study. Subjects were patients over the age of 18, or their family representative, who visited the ED. Subjects were randomly assigned to either the original routine explanation for consent or the video-assisted explanation. Patients completed a questionnaire about contrast adverse effects and the proposed treatment.

Results. Mean values of the degree of understanding of informed consent were relatively higher in the video-assisted group. When assessing the proficiency of the informer, the score for understanding and satisfaction was higher in the attending staff informed group than the house staff informed group.

Conclusion. This study showed a higher level of understanding in the group that was provided information using visual aids, rather than in the traditional way. Also, a higher level of understanding and satisfaction was shown among those who were given explanations by an attending staff member.

The busy ED, due to factors such as overcrowding, is expected to see benefit from appropriately utilizing multimedia visual aids, and also from more experienced medical staff providing information.

Key words: informed consent, intravenous contrast, visual aids

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Clinical Trials

Abstract

The clinical practice of resuscitation science is dependent on discoveries generated in the basic science and animal laboratory and then translated into clinical trials for application in humans. The successful implementation of prospective, randomized, controlled, clinical trials in the field of cardiac arrest remains challenging and continues to evolve. Funding for clinical trials of cardiac arrest is limited, and there are significant obstacles to performing such studies because of the inability to obtain informed consent under these emergency circumstances. The absence of reliable national statistics on cardiac arrest, evaluation of neurological outcome, and potential confounders such as post-resuscitation hospital-based care and quality of cardiopulmonary resuscitation (CPR) continue to challenge cardiac arrest clinical trials. Nonetheless, the immense public health burden of cardiac arrest is being recognized, appropriate public health initiatives to address the problem are being implemented, and the resuscitation research community is meeting this challenge.

Keywords: resuscitation, clinical trials, funding, informed consent, neurological and functional assessments, standards

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