Case 1 of 17Communication and ProfessionalismObtaining informed consent (e.g., capacity assessment)
A 16-year-old girl is assessed on postoperative day 1 after posterior spinal fusion for adolescent idiopathic scoliosis. Surgical drains continue to output blood and she feels light-headed. Her hemoglobin is 62 g/L (115-155) and was 118 g/L before surgery. She and her parents are Jehovah's Witnesses; both parents are at the bedside and state that she will not receive blood products. The patient says, "This is my decision." She has no allergies and takes no regular medications.
| Heart rate | 118/min |
| Respiratory rate | 20/min |
| Temperature | 37.2 °C |
| O2 saturation | 97%, room air |
| Blood pressure | 102/60 mm Hg |
Question 1 of 51
Which of the following are the most appropriate next steps?
Select 2. (0 / 2 selected)
100%
AAsk which blood fractions and alternatives she would accept
BPresume capacity because she is 16 and proceed without assessment
CObtain a court order for transfusion before further discussion
DInterview the patient alone to assess capacity and voluntariness
EAccept the parents' refusal as the substitute decision
FDelay the discussion until the bleeding has stopped
GReport the parents to child protection services immediately
HTransfuse red blood cells now under the emergency exception
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