Paeds Cases · investigations-procedures-and-technology
Consent and prepare a child for a procedure — OSCE
OSCE communication and procedural-readiness station: assess a 4-year-old for intravenous cannulation on the ward, take valid consent and assent, deliver the developmentally matched preparation conversation, assemble the bedside comfort bundle, and explain the restraint-versus-comfort-position distinction and the documentation that makes the encounter defensible.
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You are the paediatric registrar on the ward. A 4-year-old child needs an intravenous cannula for antibiotic therapy. The bedside team has suggested holding the child down. You have 8 minutes to take valid consent and assent, deliver the preparation conversation, outline the comfort bundle, and explain your approach to restraint and the documentation. [1]
The four tasks are: take valid consent and developmentally appropriate assent from the parent and child and explain the framework you are using; deliver the preparation conversation for this preschool child and her anxious parent, including what to say, what to avoid, and how you will brief the parent; outline the bedside comfort bundle you will assemble; and explain your approach to restraint versus a comfort position and the documentation you will complete. [1] [3]
You may use the parent as the simulated participant. You do not need to perform the cannulation. [6]
References6ShowHide
- [1]Katz AL, Webb SA Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
- [2]COMMITTEE ON BIOETHICS, American Academy of Pediatrics Informed consent, parental permission, and assent in pediatric practice. Pediatrics, 1995.PMID 7838658
- [3]Birnie KA, Noel M, Chambers CT, et al Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev, 2018.PMID 30284240
- [4]Harrison D, Reszel J, Bueno M, et al Breastfeeding for procedural pain in infants beyond the neonatal period. Cochrane Database Syst Rev, 2016.PMID 27792244
- [5]Taddio A, Riddell RP, Ipp M, et al Relative effectiveness of additive pain interventions during vaccination in infants. CMAJ, 2017.PMID 27956393
- [6]Coyne I Children's participation in consultations and decision-making at health service level: a review of the literature. Int J Nurs Stud, 2008.PMID 18706560