1.3.2 Practical Aspects of ECT Administration

1.3.2 Practical Aspects of ECT Administration

The Practical Aspects of ECT Administration

Electroconvulsive therapy (ECT) is a medical treatment that involves passing an electrical current through the brain to induce a brief seizure. It is used to treat various mental health conditions, including severe depression, bipolar disorder, and schizophrenia. The administration of ECT involves several practical aspects that must be carefully considered to ensure its safety and effectiveness.

Pre-treatment:

Procedures Before administering ECT, several procedures must be followed to ensure the safety of the patient. These include:

  1. Medical Evaluation: A thorough medical evaluation must be performed to assess the patient’s overall health and identify any conditions that may increase the risk of complications during ECT.
  2. Anaesthesia: ECT is typically administered under general anaesthesia to prevent the patient from feeling pain and to reduce the risk of injury during the seizure.
  3. Muscle Relaxants: A muscle relaxant is often given to the patient to prevent convulsions from becoming too severe and causing injury.
  4. Electrode Placement: Electrodes are placed on the patient’s scalp to deliver the electrical current to the brain. The placement of electrodes is determined by the patient’s medical history, the type of ECT being administered, and the treating physician’s preference.

ECT procedure:

The ECT procedure itself involves the following steps:

  1. Electrode Placement: After the patient is under anaesthesia, the electrodes are placed on the patient’s scalp in the predetermined location.
  2. Electrical Current: A brief electrical current is passed through the electrodes to induce a seizure.
  3. Seizure Monitoring: The patient’s seizure is monitored to ensure that it is safe and effective.
  4. Recovery: The patient is carefully monitored as they recover from the effects of the anaesthesia and the ECT.

Risks and side effects:

Like any medical treatment, ECT carries some potential risks and side effects. These can include:

  1. Short-term Memory Loss: The patient may experience short-term memory loss immediately after ECT.
  2. Confusion: Some patients may feel confused or disoriented after ECT.
  3. Headache: Headaches are a common side effect of ECT.
  4. Nausea: Nausea and vomiting may occur in some patients.
  5. Fractures: Fractures can occur if convulsions become too severe during ECT.

Summary of the practical aspects of ECT administration:

Pre-treatment ProceduresECT ProcedurePotential Risks and Side Effects
Medical evaluationElectrode placementShort-term memory loss and confusion
AnaesthesiaElectrical currentHeadache
Muscle relaxantsSeizure monitoringNausea
Electrode placementRecoveryFractures

References:

  1. American Psychiatric Association. (2016). The practice of electroconvulsive therapy: Recommendations for treatment, training, and privileging. American Psychiatric Association Publishing.
  2. National Institute for Health and Care Excellence (NICE). (2019). Electroconvulsive therapy. Clinical guideline [CG59]. Retrieved from https://www.nice.org.uk/guidance/cg59/chapter/Recommendations.