2/6 (ECT)

Insulin shock therapy (not used anymore)

  • can cause hypoglycemic shock leading to death

  • high frequency is dangerous (can be 5x weekly)

  • usage of mouth guard can break

  • usage of restraints, both by cuffs and medical staff

ECT indications

  • schizophrenia with catatonic features

  • MDD

  • withdrawn

  • waxy flexibility

  • behavior stupor

  • no ADL or eating; no self care

  • blocking

  • poverty of speech

  • mutism

  • medications are not stimulating the neurotransmitters

    • anti depressants can take weeks (2wk) to start working, and some cannot wait that long

ECT contradictions

  • have to be medically stable first

ECT side effects

  • partly due to mild anesthetic given

  • confusion

  • disorientation

  • temporary memory loss

  • often lasting 30mins

ECT is done in pt for observation

  • if the hospital itself does not offer it, pt will be taken via ambulance to a facility that does

Role of the nurse

  • PTS have to be NPO from midnight the night prior

  • void prior

  • remove any accessories

  • atropine sulfate (robinul) is given 30 mins before treatment

    • reduces secretions (prevents aspiration)

  • succinylcholine (mild anesthetic) is also given

    • relaxes muscles

    • removes need for the pt to be restrained

    • full body convulsions are absent, but you may see mouth or toes twitching

  • adm air during and after

  • airway/bite block may be used to promote airway patency

  • pt may complain of headache after procedure