title: Application of informed consent principles in the emergency department evaluation of febrile children at risk for occult bacteremia.
abstract: Informed consent requires that the risks and benefits of a particular diagnostic and therapeutic plan be reviewed with the patient, including the disclosure of alternative diagnostic and treatment approaches. Although it could be argued that it is difficult to present all the diagnostic and therapeutic options to parents in the E.D. management of febrile children at risk for occult bacteremia, it is the purpose of this report to describe the experience with following these principles of informed consent in a group of these children.
  
  
  METHODS
  Convenience sample of febrile children presenting to an E.D. at risk for occult bacteremia. A standardized information sheet was presented. A parent survey of preferences followed.
  
  
  RESULTS
  In 37 patients, most of the parents chose no tests and preferred to be involved in the medical decision making process for their child.
  
  
  CONCLUSIONS
  While preferred by parents and supported by AAP, the process of informed consent, for febrile children at risk for occult bacteremia, is time consuming and often not possible when the E.D. is busy. Physicians may find it desirable to make decisions from an informed consent perspective to a comfort level dependent on time availability, parents' comprehension ability, and individual personal practice preference.
authors.affiliation: Department of Pediatrics, University of Hawaii, John A. Burns School of Medicine, Honolulu 96826, USA. loreny@hawaii.edu
authors.forename: L G
authors.initials: LG
authors.lastname: Yamamoto
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D002675:Child, Preschool; D032962:Consent Forms; D030881:Disclosure; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D005335:Fever of Unknown Origin / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D006254:Hawaii; D006801:Humans; D007223:Infant; D007258:Informed Consent; D008297:Male; D033282:Parental Consent; D010290:Parents; D018570:Risk Assessment; D012494:Sampling Studies; D035501:Uncertainty
chemical_list: D000900:Anti-Bacterial Agents