The patient's consent to anesthesia (anesthetic support, provision and anesthesia) is reflected in the medical form confirming the patient's voluntary consent to the appropriate procedure. Such a form, given to the patient, informs him of the upcoming type of anesthesia, possible risks or complications, and, in addition, of the consequences in case of refusal of anesthesia. The patient's consent form for anesthesia must be filled out in the planned and emergency form of this medical service.
What are the standards of anesthesia care
As you know, absolutely all patients, as a rule, are different. For example, some of them want to get complete information about the types of anesthesia, and, in addition, about modern drugs and so on. But others, in turn,even want to hear about what is included in the concept of general or regional anesthesia. In such a case, it can be assumed that a certain part of the patients will be left without reliable information.
On the other hand, information may be deliberately withheld by the anesthesiologist, but only on the condition that the patient does not require it. Most legal portals that deal with issues of patient informed consent to anesthesia report that in any case, patients need to be told about upcoming anesthesia options, taking into account the clinical diagnosis, age and personality type of the patient. True, the question of what can be said and what should not always remains open. This answer can be found in the concept of "deontology".
Thus, every patient has the right to be informed about their he alth status and recommended medical and surgical diagnostic procedures. Such information makes it possible, knowing the risks and dangers, to decide whether to undergo or refuse the proposed procedure.
What are the features of anesthesia care?
Features and Protocol
Let's look into this issue in more detail.
As part of the acceptance of the anesthetic allowance, the patient's confirmation is recorded that he was acquainted with all the basic facts that relate to the essence and features of the medical service provided.
It is when performing an operation or somemedical procedure, firstly, is required for pain relief. And besides, it is necessary to ensure continuous control over the patient's condition, including support for his blood circulation, full breathing and other important body functions.
Anesthesiology protocol confirms this.
In addition, the benefit may include the prevention of a possible complication during surgery, along with timely detection and minimization of its consequences.
What types of anesthesia care are there?
Today, there are several types of anesthesia:
- Administration of general anesthesia.
- Performing regional anesthesia.
- Implementation of local anesthesia.
- Performing monitored sedation.
It is worth noting that absolutely any type of anesthesia can present certain risks. The overall risks of death associated with anesthesia are approximately one in ten thousand anesthetics performed. In relatively he althy people, this risk is significantly lower, at one in fifty thousand cases of anesthesia.
Despite the fact that the outcome of anesthesia is usually favorable, however, during the operation, there may be a significant fluctuation in the activity of the cardiovascular system, and, in addition, the patient's breathing, medical errors with equipment malfunctions and so on cannot be ruled out. In most situations, such disorders can be successfully eliminated by the anesthesiologist. However, under certain conditions, this can lead to the developmentadditional pathologies, which are called complication of anesthesia.
What is on this form?
In such a document, the person confirms that the anesthesiologist informed him about the anesthetic allowance expected for him. It confirms receipt of an anesthesiologist's order to stop eating and drinking for a certain period of time. The patient also confirms that he was explained all the dangers that can arise in case of non-compliance with this or that prescription. The patient undertakes not to hold the medical institution and anesthesiologists responsible for the possible consequences that may appear in case of violation of any prescription.
Among other things, in this form of anesthesia, the patient claims to have informed the anesthesiologist about all the pathologies suffered, surgery, allergies to certain substances and other other facts that relate to treatment. Thus, patients confirm that they will not place any responsibility on the medical institution, as well as on anesthesiologists, for the consequences that could arise in the absence of this information. The patient also claims that he was not given promises with guarantees regarding any outcome of anesthesia by the anesthesiologist and other employees of this or that medical institution.
The Anesthesia Benefit Consent Form also provides information about complications. The person must indicate thatit was explained to him that his general state of he alth corresponded to a certain class according to a five-point anesthetic classification. For example, a statistical study showed that the probability of complications during anesthesia in patients of the second category is twice as high, in the third three times, and in the fourth and fifth classes four times as compared with patients of the first category.
Anesthesia Benefit Consent Form
As part of their consent, patients state that they were given the opportunity to discuss their condition along with the proposed allowance with an anesthetist. Patients note that they received satisfactory answers to all questions. In addition, it is emphasized that the patient was given enough time to make a decision. Anesthesiologists generally provide patients with a second opinion to make a final decision.
Thus, patients voluntarily, without external pressure, give the authority to the doctor anesthesiologist, and, in addition, the resuscitator to carry out the planned anesthesia care for them.
On what points is consent given for anesthesia?
As a rule, consent is given on the following points:
- Consent to permission to carry out planned assistance, as well as to perform alternative methods of pain relief if the anesthesiologist deems it necessary.
- Consent to permit the anesthesiologist in the event that he deems it necessary to involve for performanceanesthesia under the supervision of other doctors, nurses and other staff of the therapeutic institution and students.
- Consent to allow the anesthesiologist to publish information about anesthesia for educational and scientific purposes, accompanied by descriptive texts and special illustrations, excluding the possibility of identifying the patient.
What are the components of anesthesia care?
Colonoscopy anesthesia and drug components
Colonoscopy is a procedure for examining the large intestine, as well as the end region of the small intestine, using a thin, flexible, fiber-optic instrument that consists of a light source and, in addition, a camera that produces images on a television screen.
Different types of anesthesia in colonoscopy are used in different clinics of our country. It is not so rare that it is done without any anesthesia at all, however, this medical procedure is considered quite unpleasant, and, moreover, also painful. Sometimes a colonoscopy is performed under local anesthesia. The tip of the colonoscope is lubricated with a local anesthetic. It is worth noting that local anesthesia does not provide sufficient comfort for the procedure.
The most optimal and frequently used type of anesthesia in European countries during colonoscopy is sedation. Sedation can induce a state similar to sleep, while the patient's anxiety and fear disappear, and, in addition, any sensations are blunted as much as possible. To perform sedation during a colonoscopy procedure, most oftenMidazolam or Propofol is used. Both of these drugs have their own advantages and disadvantages. The advantage of "Midazolam" in the first place is that its use does not cause any memories in patients about the past procedure. The disadvantage of "Midazolam" is a longer period of awakening immediately after its use. A drug called Propofol provides a relatively quick wake up after the sedation phase, at the cost of some risks of retaining memories of a past colonoscopy.
General anesthesia what does a colonoscopy involve?
Another option for pain relief, which is used during colonoscopy, is general anesthesia (that is, the use of anesthesia), which provides an absolute shutdown of patients' consciousness. Sedation typically provides comfort in ninety-five percent of the cases it is used. And anesthesia during colonoscopy guarantees one hundred percent comfort. However, we should not forget at all that there are a lot of risks associated with anesthesia during colonoscopy compared to the use of sedation techniques. In order to conduct anesthesia during colonoscopy, different drugs from the category of anesthetics can be used. Anesthesia during colonoscopy should be carried out only in an operating room that has all the required equipment in order to ensure complete safety.procedures.
Thus, anesthesia during colonoscopy is not considered rational, since the risks from its implementation exceed the danger associated with the colonoscopy procedure itself, in connection with this, colonoscopy is considered to be the most optimal for patients under sedation.
Indications for colonoscopy and possible complications
Colonoscopy is often performed with digestive bleeding, and, in addition, in case of suspicion of the development of an inflammatory or malignant neoplasm of the colon. Also, another indication for colonoscopy is an unmotivated decrease in hemoglobin among elderly patients.
In a colonoscopy, a probe is inserted into the large intestine through the anus in order to visually inspect the internal intestinal surface. Colonoscopy may include some surgical procedures, such as removing polyps along with taking a biopsy (a small piece of tissue from the large intestine). However, colonoscopy is often performed for diagnostic purposes. The duration of this procedure is usually fifteen to sixty minutes.
In general, the risks of complications from colonoscopy are extremely low, at only about 0.30%. Possible complications include perforation along with bleeding, post-polypectomy syndrome, reactions to the anesthetic, and infections. Of the possible complications from the use of anesthesia during colonoscopy, the development of allergic reactions to anesthetics is often encountered, and, in addition, the occurrence of a respiratory problem.
Children's allowance
Anesthesiology allowance for children is provided.
Its main task is to ensure the calm behavior of the child, regardless of the nature and extent of the intervention; favorable mental and vegetative state; painlessness and atraumaticity of various dental procedures.
When choosing a method of anesthesia, you must carefully consider the behavior of the child. The doctor should strive in advance to predict the behavior and condition of the child after communicating with him, performing anesthesia, during and after treatment. If you have any doubts about the choice of the method of anesthesia, consultation with doctors of other speci alties is necessary to make a final decision.
Young people over the age of sixteen are competent to consent to any type of treatment without obtaining separate consent from their parents or guardians. Children under the age of sixteen who demonstrate the ability to adequately assess the benefits and risks of planned treatment may also be considered competent to give appropriate consent.
Informed consent for anesthesia care from parents must be obtained for any patient under the age of eighteen who is not competent to provide such consent.
Use of the drug "Daralgin"
The use of "Dalargin" as a component of anesthesia is popular.
The drug under this name isanti-ulcer drug. This is a synthetic hexapeptide, which is an analogue of the substance leucine-enkephalin. This agent inhibits proteolysis and achieves rapid healing of ulcers that are localized in the stomach and intestines. The drug in question can have moderate antisecretory activity and, when used, lowers the acidity of gastric juice. In addition, it suppresses the external secretion of the pancreas, as well as its response to various stimuli.
Intramuscularly, patients are prescribed, as a rule, this medication twice a day, 1 milliliter of the drug. As part of intravenous administration, patients receive a single dose of 5 to 10 milliliters of the drug, which is diluted in an isotonic sodium chloride solution.
What else does the use of "Dalargin" as a component of the anesthetic aid involve?
If necessary, in order to achieve the required pharmacological effects, it is possible to increase the dosage to 2 milligrams, while daily intramuscular doses can be increased to 5 milligrams. The duration of therapy against this background can vary from three to four weeks. The total course dosage of the agent can vary from 30 to 50 milligrams. In the presence of a pronounced pain syndrome, it is possible to take Dalargin together with antacid drugs.
Thus, anesthesia is an integral part of any surgical treatment. But capable patients have the right to give or not givetheir consent to the appropriate therapy or examination. In order to obtain the consent of the patient, it is required to provide detailed information regarding the proposed treatment. Any manipulation that is undertaken without the consent of the patient, in a civil court can be considered as violence, and by medical advice as a serious professional violation, which will entail consequences.
We looked at what consent to anesthesia care is.
