Defining the Scope of Implied Consent in the Emergency Department

PURPOSE: 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. CONCLUSION: Defining a set of ED procedures covered under implied consent will be difficult because many patients value formal consent for even the simplest procedure.