Simulated Informed Consent Scenarios for Patients at Risk for Perioperative Visual Loss (POVL) Video
APSF has produced an 18-minute long video of simulated informed consent scenarios that are intended to guide surgeons and anesthesia professionals in providing informed consent for patients at risk for POVL due to ischemic optic neuropathy (ION)
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APSF believes the informed consent process for patients considered to be at risk for development of “perioperative visual loss (POVL)” should include the remote risk of blindness due to ischemic optic neuropathy (ION). If the risk of POVL due to ION is not part of a combined anesthesia and surgery informed consent, or part of a separate surgical informed consent, it should be part of the anesthesia informed consent.
The informed consent may include a discussion of risk factors (prolonged spine surgery in the prone position or prolonged robotic surgery in the head down position, increased blood loss, male gender, obesity, use of Wilson surgical frame) and the current understanding of steps to take to reduce the likelihood of POVL due to ION (minimize duration of surgery, consider staged spine procedures, keep head at or above the level of the heart, minimize use of surgical frames that place the head lower than the heart, and include colloid in nonblood replacement).
The following simulated informed consent scenarios are intended to provide guidance to surgeons and anesthesia professionals in managing the informed consent process for patients at risk for POVL due to ION.