Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a procedure in which electric currents are passed through the brain, deliberately triggering a brief seizure. Electroconvulsive therapy seems to cause changes in brain chemistry that can immediately reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful.

Nurses have an important role to deliver when a client is to undergo Electroconvulsive Therapy. Find out what are the responsibilities and activities of the nurse during electroconvulsive therapy.

Emotional and Educational Support to the Client & Family

  • Encourage the client to discuss feelings, including myths regarding ECT.
  • Teach the client and the family what to expect with ECT.

Pre-treatment Protocol for ECT

  • Ascertain if the client and the family have received a full explanation, including the option to withdraw the consent at any time.
  • Withhold food and fluids for 6 to 8 hours before treatment.
  • Remove dentures, glasses, contact lenses, hearing aids, hair pins and etc.
  • Have client void before the treatment.
  • Give preoperative medications as ordered:
    • Give either glycopyrrolate (Robinul) or atropine to prevent potential for aspiration and to help minimize brady-arrhythmias in response to electrical stimulants.

Nursing Care During the Procedure

  • Place a blood pressure cuff on one of the client’s arms.
  • As the intravenous line is inserted and EEC and ECG electrodes are attached, give a brief explanation to the client.
  • Put on the pulse oximeter to the client’s finger.
  • Monitor blood pressure throughout the threatement.
  • Medications to be given:
    • Short-acting anesthethic (Brevital)
    • Muscle relaxant (Succinylcholine)
    • 100% oxygen by mask via positive pressure
  • Check if the bite block is placed in prevent biting of the tongue
  • Electrical stimulus given (seizure should last 30 to 60 seconds).

Post treatment nursing care

  • Have the client go to a properly staffed recovery room.
  • Once the client is awake, talk to the client and check the vital signs.
  • Give frequent orientation and reassurance to allay confusion.
  • Check the gag reflex before giving client fluids, medications or breakfast.

References

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