DOI: 10.54996/anatolianjem.1881354 ISSN: 2651-4311

Emergency Physicians’ Approaches to Informed Consent and Electronic Informed Consent for Intramuscular Injections: Field Data

Resul Çinpolat, Şeyhmus Kaya, Vehbi Özaydın, Banu Karakuş Yılmaz
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Aim: Intramuscular injections are among the most frequently performed procedures in daily emergency department practice. Although these interventions are generally regarded as low risk, considerable variation exists in how informed consent is obtained in routine clinical settings. With the most recent legal amendment, the possibility of obtaining informed consent electronically has been incorporated into legislation; however, no clear framework has yet been defined regarding its implementation. This study aimed to examine current informed consent practices for intramuscular injections in emergency departments, the challenges encountered by physicians, and their views on electronic informed consent.Material and Methods: This study was designed as a descriptive, cross-sectional survey. A 16-item online questionnaire developed by the research team was distributed nationwide to physicians working in emergency departments through Emergency Medicine Association of Türkiye. The survey addressed participants’ professional characteristics, approaches to obtaining informed consent for intramuscular injection procedures, views on written consent, awareness regarding the legal proof of consent, and opinions on electronic consent practices. Data were collected between June 30, 2025, and January 1, 2026.Results: The minimum target sample size for the study was determined to be 384, and a total of 409 emergency physicians participated in the study. The median age of participants was 31 years (IQR 27–39), and the median duration of emergency department experience was 4.5 years (IQR 1.4–12.0). Although 77.8% of participants stated that written informed consent should be obtained for intramuscular injections, only 32.5% reported routinely obtaining written consent in practice. Among those who reported obtaining written consent, only 34.6% indicated that they could easily access previously obtained consent records when needed. Most participants (73.1%) stated that, in the event of a legal dispute related to an intramuscular injection, the burden of proof would rest with the healthcare professional and/or the healthcare institution. The most commonly reported difficulties in obtaining written consent were high patient volume and limited time. Overall, 77.5% of participants considered electronic informed consent to be a more practical option. The most frequently preferred electronic method was providing consent by signing with an electronic pen on a touch-screen monitor installed in the examination room.Conclusion: This study demonstrates that, in emergency departments, obtaining written informed consent for intramuscular injection procedures remains limited in routine practice and is associated with challenges in documentation and traceability. Given the high workload and time constraints inherent to emergency care, electronic informed consent—if appropriately designed—may facilitate practical implementation for emergency physicians. In addition, electronically documented consent may represent a valuable option for enhancing legal security.

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