Electroconvulsive Therapy Program
THE TREATMENT TEAM AND THEIR ROLES
Typically, ECT is performed by a team of medical professionals specifically trained in the delivery of ECT. This team consists of a psychiatrist, anesthesiologist, and nursing staff. The psychiatrist commonly delivers the ECT stimulation. The anesthesia team administers medications and monitors your medical status throughout the procedure. After the treatment, nursing staff will continue to monitor your progress until you return to the inpatient or outpatient unit.
The night before a treatment you will not have anything to eat or drink after midnight. Some people may receive medications in the morning with a sip of water for headache, high blood pressure, stomach reflux, or other significant medical conditions.
Shortly after you arrive in the ECT treatment area, an ECT team member will insert a catheter into your vein, often referred to as an IV. The IV will be used to administer medications necessary for both the ECT and your comfort. Pads with monitoring wires will be placed on your head and upper body to monitor your brain waves and your heart during the procedure. Blood pressure cuffs will be placed on both your upper arm and lower right leg. The cuff on your arm will be used to monitor your blood pressure. The cuff on your leg will be used to prevent the muscle relaxant medication from traveling to your foot, allowing the psychiatrist to monitor your motor seizure.
Treatment Preparation and Medication Administration
You will then be given a medication to make you sleepy. At the same time, a mask will be placed over your nose and mouth. The mask is used to provide you with oxygen.
When you are completely asleep, a muscle relaxant will be administered to prevent your muscles from twitching. After your muscles are sufficiently relaxed, two electrodes will be placed on your scalp and a pulse of electricity will be administered. Seizures vary, but are generally in the 25 to 45 second range.
You will be closely monitored during and immediately after this treatment. After you awaken and your vital signs are stable, you will be transferred to the recovery area. The ECT treatment generally lasts only 10 to 20 minutes.
In the recovery area, the nurse will closely monitor your blood pressure and level of consciousness for another 20 to 30 minutes. Once the anesthesiologist is satisfied that you are ready, you will return to the inpatient or outpatient unit.
Upon arrival in the inpatient or outpatient unit, your vital signs and level of consciousness will be checked again. As soon as you are alert, you will be provided with food and beverages and assisted with dressing as needed. At this point, if you are an outpatient, you will be released in the care of the person who accompanied you to the hospital. If you are an inpatient, you will be encouraged to participate in unit activities, or you may continue to rest if you are feeling tired.