Defining the scope of implied consent in the emergency department.
OBJECTIVE
To determine the relative value that patients place on consent for procedures in the emergency department (ED) and to define a set of procedures that fall in the realm of implied consent.


METHODS
A questionnaire was administered to a convenience sample 134 of 174 patients who were seen in the ED of a Midwestern teaching hospital. The questionnaire asked how much time they believed was necessary to give consent for various procedures. Procedures ranged from simple (venipuncture) to complex (procedural sedation).


RESULTS
Participants valued a simple blood draw at a low mean of 1.02 minutes of extra time and a lumbar puncture at a high mean of 7.78 minutes. Of all participants 52% and 48% noted a time-value of "0" time on blood draw and intravenous line starts, respectively, indicating that they desire no additional consent for these procedures.


CONCLUSIONS
Defining a set of ED procedures covered under implied consent will be difficult because many patients value formal consent for even the simplest procedure.
D000328:Adult; D002405:Catheterization, Central Venous; D002406:Catheterization, Peripheral; D016292:Procedural Sedation; D004322:Drainage; D004636:Emergency Service, Hospital / Q000941:ethics / Q000592:standards; D004638:Emergency Treatment / Q000941:ethics / Q000592:standards; D026690:Ethics, Clinical; D005260:Female; D005592:Fracture Fixation; D006784:Hospitals, Teaching; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000592:standards; D007441:Intubation, Gastrointestinal; D008297:Male; D015146:Midwestern United States; D018962:Phlebotomy; D013129:Spinal Puncture; D011795:Surveys and Questionnaires; D013537:Sutures; D013997:Time Factors