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Review Question - QID 619

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QID 619 (Type "619" in App Search)
A 25-year-old man sustains a Grade III-A open tibial shaft fracture secondary to a motorcycle accident. The patient is unconscious and has no family members who can be reached for consent. What is the most appropriate course of action?

Document the necessity for treatment and proceed immediately with definitive fracture care

21%

226/1069

Proceed with a preliminary irrigation and debridement in the emergency department, apply a splint, and wait for him to regain consciousness before proceeding with definitive treatment

10%

106/1069

Contact a hospital administrator for approval of care

2%

22/1069

Confirm and document the necessity of care with a colleague with similar expertise and knowledge prior to proceeding with surgery

65%

697/1069

Proceed immediately to the operating room for definitive treatment without further documentation

1%

10/1069

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A legal guardian should provide informed consent in the case where a patient does not have capacity and needs emergency surgery. Next in chain of command is a family member if no legal guardian exists. Lastly, if neither a guardian or family member is available, it is appropriate to have another physician, with similar expertise and knowledge as the proposed surgeon, confirm the necessity of the procedure. This should be well-documented prior to proceeding with the procedure.

The article by Naarden and Cissik reviews strategies to improve the informed consent process.

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