Intraoperative Decision Making: The Decision to Perform Additional, Unplanned Procedures on Anesthetized Patients

Langerman, Alexander; Siegler, Mark; Angelos, Peter

doi:10.1016/j.jamcollsurg.2016.02.011

Cited by 10 publications

(1 citation statement)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IONM false-positive rates, surgeon IONM inexperience, and technical failures are the main reasons IONM may provide unreliable results ( 1 , 2 ). According to the literature, device malfunction or false IONM results may occur in 1% to 13% of procedures ( 1 , 2 , 79 , 80 ).…”

Section: Defining the Standard Of Ionm Informed Consentmentioning

confidence: 99%

Informed Consent for Intraoperative Neural Monitoring in Thyroid and Parathyroid Surgery – Consensus Statement of the International Neural Monitoring Study Group

Wu¹,

Huang²,

Randolph³

et al. 2021

Front. Endocrinol.

Self Cite

View full text Add to dashboard Cite

In the past decade, the use of intraoperative neural monitoring (IONM) in thyroid and parathyroid surgery has been widely accepted by surgeons as a useful technology for improving laryngeal nerve identification and voice outcomes, facilitating neurophysiological research, educating and training surgeons, and reducing surgical complications and malpractice litigation. Informing patients about IONM is not only good practice and helpful in promoting the efficient use of IONM resources but is indispensable for effective shared decision making between the patient and surgeon. The International Neural Monitoring Study Group (INMSG) feels complete discussion of IONM in the preoperative planning and patient consent process is important in all patients undergoing thyroid and parathyroid surgery. The purpose of this publication is to evaluate the impact of IONM on the informed consent process before thyroid and parathyroid surgery and to review the current INMSG consensus on evidence-based consent. The objective of this consensus statement, which outlines general and specific considerations as well as recommended criteria for informed consent for the use of IONM, is to assist surgeons and patients in the processes of informed consent and shared decision making before thyroid and parathyroid surgery.

show abstract

Section: Defining the Standard Of Ionm Informed Consentmentioning

confidence: 99%

Informed Consent for Intraoperative Neural Monitoring in Thyroid and Parathyroid Surgery – Consensus Statement of the International Neural Monitoring Study Group

Wu¹,

Huang²,

Randolph³

et al. 2021

Front. Endocrinol.

Self Cite

View full text Add to dashboard Cite

show abstract

Transparency in Surgery

Makhoul

Drolet

Langerman

2022

Difficult Decisions in Surgery: An Evidence-Based Approach

View full text Add to dashboard Cite

Ethics Consultation in Surgical Specialties

2021

View full text Add to dashboard Cite

Multiple studies have been performed to identify the most common ethical dilemmas encountered by ethics consultation services. However, limited data exists comparing the content of ethics consultations requested by specific hospital specialties. It remains unclear whether the scope of ethical dilemmas prompting an ethics consultation differ between specialties and if there are types of ethics consultations that are more or less frequently called based on the specialty initiating the ethics consult. This study retrospectively assessed the incidence and content of ethics consultations called by surgical vs. non-surgical specialties between January 1, 2013 to December 31, 2018 using our RedCap Database and information collected through the EMR via our Clinical and Translational Science Center. 548 total ethics consultations were analyzed (surgical n = 135, non-surgical n = 413). Our results demonstrate that more surgical consults originated from the ICU, as opposed to lower acuity units (45.9% vs. 14.3%, p ≤ 0.001), and surgical patients were more likely to have a DNR in place (37.5% vs. 22.2%, p = 0.002). Surgical specialties were more likely to call about issues relating to withholding/withdrawing life-sustaining treatment (p ≤ 0.001), while non-surgical specialties were more likely to call about issues related to discharge planning (p = 0.001). There appear to be morally relevant differences between consults classified as the “same” that are not entirely captured by the usual ethics consultations classification system. In conclusion, this study highlights the unique ethical issues experienced by surgical vs. non-surgical specialties. Ultimately, our data can help ethics consultation services determine how best to educate various hospital specialties to approach ethical issues commonly experienced within their field.

show abstract

Intraoperative Decision Making: The Decision to Perform Additional, Unplanned Procedures on Anesthetized Patients

Cited by 10 publications

References 13 publications

Informed Consent for Intraoperative Neural Monitoring in Thyroid and Parathyroid Surgery – Consensus Statement of the International Neural Monitoring Study Group

Informed Consent for Intraoperative Neural Monitoring in Thyroid and Parathyroid Surgery – Consensus Statement of the International Neural Monitoring Study Group

Transparency in Surgery

Ethics Consultation in Surgical Specialties

Contact Info

Product

Resources

About