Taking consent is a common examination question. It is key to avoid medical jargon and have a structured format. The following format (“YMCA”) is often useful to use as a template when consenting a patient:
Y (Why Have the Procedure)
Explain the disease pathophysiology and how the proposed intervention alters this. What are the expected benefits?
M (Mechanism, What is the Procedure)
- What is involved (draw a diagram)
- Duration
- Anaesthetic considerations: Local anaesthetic (LA) vs. General anaesthetic (GA)
- Pre-operative preparation: Fasting, ± stop anticoagulants, optimise diabetes
- Post-operative expectation: Need for admission, dressings, eyedrops, follow-up
C (Complications)
- Most common
- Most important (including anaesthetic-related)
Provide contact details and a plan for patients if they have post-operative concerns.
“I will give you my contact details if you have any problems”.
A (Alternatives)
- Observation (describe the natural history of the condition)
- Medical therapy
- Other operations
(Extra Questions)
- Allergy
- Pregnancy
Special Considerations in Pregnancy
A. Drops
- Refer to pharmacopeia regarding safety in pregnancy
- Punctal occlusion (manual and / or plugs)
B. Surgery
- Anaesthetic issues
- Posture (especially in third trimester)
- Greater risk of suprachoroidal haemorrhage: Use AC maintainer, tight sutures
C. Consult with Anaesthetist / Obstetrician
Confirm that the patient understands. Any questions?
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Vitreoretinal Surgery Online
This open-source textbook provides step-by-step instructions for the full spectrum of vitreoretinal surgical procedures. An international collaboration from over 90 authors worldwide, this text is rich in high quality videos and illustrations.
