TYK109
You have been asked to cover an emergent case coming from the emergency department. A 13-year-old boy has a fracture which occurred during a football game at school. He has been accompanied by the school nurse as his parents are both at work and you are unable to reach either parent by telephone. The orthopedic surgeon contacts you and states that this case must proceed immediately as they are concerned that the child’s affected extremity may have compartment syndrome. The child is transported to the operating room and upon arrival is upset and screaming. He tells you that he “does not want surgery” and that “he is old enough to make his own decisions”. He continues to protest and physically resist your attempts and states that “his dad is a lawyer and we’ll sue you for assault”.
What is your next step?
a) Delay surgery while you continue attempts to contact the patient’s parents to obtain verbal telephone consent
b) Respect the patient’s wishes and refuse to administer anesthesia
c) In the best interest of the child, sedate and anesthetize the child for the emergent procedure
d) Call risk management and await their advice in how to proceed with this situation