This study investigated the issue of informed consent by surveying parent preferences for
local anesthesia and sedation in the repair of small
lacerations in their children in the emergency department (ED). Of the 45 ED patients with actual
lacerations receiving a
suture repair, 11 requested
tetracaine-
adrenaline-
cocaine (TAC), 25 requested infiltrated
lidocaine, and 9 were not given a choice (
lidocaine administered because of
wound proximity to a mucous membrane site). All 45 patients preferred nonsedation over sedation. In 44 of 45 patient cases, parents preferred to be included in the medical decision-making for their children. Of the 94 non-ED cases (interviewed in private offices) with a hypothetical chin
laceration, 16 preferred TAC and 78 preferred infiltrated
lidocaine. Sixty-seven of 94 preferred nonsedation over sedation. In 89 of 94 patient cases, parents preferred to be included in the medical decision-making for their children. Favorable points of continuous informed consent were presented, with risks, benefits, and alternatives disclosed. From the data presented, the following conclusions were drawn: (1) parents preferred infiltrated
local anesthesia more commonly than topical
local anesthesia; (2) parents preferred nonsedation over sedation under the clinical circumstances described; (3) parents overwhelmingly preferred to be included in the medical decisions affecting their children.