Consent form

[interjectionreflection]

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How is everyone doing consent forms?

I put every level and site I intend to inject but I talked to some of the others at my centre and they will only list the procedure Ie. Lumbar epidural, lumbar facet/MBB but not the site or levels. The surgeon's in the group also don't specify levels and consent "multilevel decompression". I always talk to patients about injection at alternate side and dictate that into my note but it got me wondering if the standard is to not.

 

[SgtThunderfistMD]

ILESI I don't put a level since I may have to pivot to a higher/lower level if I can't access at the intended level.

TFESI, LMBB, etc should all have the specific level IMO since you're not going to deviate from the plan. If there is any question (for example, you need to look at what levels of thoracic spine they are having pain under x-ray after marking the painful spot in pre-op), you can put "vs" to delineate the options: "Bilateral L1-3 Medial branch block vs T12-L2 medial branch block" to cover all your bases.

 

[Ducttape]

i believe we are supposed to put the specific level, from a legal standpoint. at least, that is what i have been told....

in terms of not knowing the level, and deciding on what level to do based on fluoro, i generally will give consent for the global area and note "site to be determined under fluoroscopic guidance". not sure of the legality, however.

 

[PainAnonymous]

For things we arent sure of level for example if im doing a paravert or intercostal block we will put "Bilateral intercostal block, level to be determined under fluoroscopy"

We've also made the change where we don't say medial branch blocks anymore.

Now we say "Test Block of Right Lumbar 4-5 and Lumbar 5-Sacral 1 facet joints" for our MBB and
"Radiofrequency ablation of Right Lumbar 4-5 and Lumbar 5-Sacral 1 facet joints" for our RFAs

I guess insurance was doing insurance things so we made that change.