What is ECT?
ECT is basically an electric shock delivered to the brain which produces fits or seizures in the person receiving it. It has been controversial since it was first introduced and remains so today.
ECT is basically an electric shock delivered to the brain which produces fits or seizures in the person receiving it. It has been controversial since it was first introduced and remains so today.
How many times is it given?
Usually between 6 and 12 times in a course of treatment.
How is it done?
-The patient is asked to lie down on a bed in the treatment room. Their shoes, dentures, watches and jewellery are then removed.
-Present in the room should be an anaesthetist (a doctor who specialises in putting you to sleep, looking after you while you are asleep, and then waking you up again), a pyschiatrist (a medical doctor specialising in mental illness), and one or more nurses.
-The patient is hooked up to a few monitors via electrodes (or to most people sticky pads), generally placed on their head and fingers. These allow the doctors to monitor the patient during the treatment. The patient is then given injections. This is usually done via a needle that is inserted in the back of the hand, this is only done once and allows more than one drug to be put into the body without the need for a lot of injections.
-The first drug injected puts the patient to sleep. Often at this point the patient will be given an oxygen mask to try and enrich the amount of oxygen in their blood, and thus reaching their brain and vital organs. Once the anaesthetist is satisfied that all the vital signs being monitored are safe, they will inject another drug. This is a muscle relaxant, that is designed to reduce the physical effects of the fit that the treatment will produce. In other words to stop peoples' arms and legs flailing around when they fit as this may injure them or other people.
-The current is then charged up to the right level, this is typically around 80 volts. The psychiatrist then puts two padded electrodes on the patient's temples (or occassionally on the same side of the head), and the person is given a shock. Almost immediately, the patient stiffens as their muscles tighten up, and they will start to twitch. The anaesthetist will pass a tube down the patient's throat to ensure that the person can breathe and doesn't choke. The amount of time the twitching lasts is written down, this is basically how long the fit lasts.
-Once the fit has finished, and the team is certain that there are no medical complications, the patient is ready to be woken up. A nurse will monitor a persons' recovery, and remove all the tubes and leads that were used in the treatment. This is often done in a specialised recovery room. When the person wakes up they are usually given a cup of tea or some such similar drink, and left for a while longer before they are ready to return to a hospital ward.
Discussion for issue:
Is there always a negative outcome from the ect to the patient, health professionals and family?
Does any study done on patient experience after the ect?
Does it negatively perceived by patient or positively or both?
Though ect is perceived as negative practice for some health professional, is the new generation of health professionals still learn or being teach about performing ect to patient in mental health nursing?
Performing ect was influenced by the ward regulartory procedure and to which extent the health professionals come to an agreements of performing ect.
In the local setting, few years back, when clozapine was not yet famous as the first line treatment, only risperidone was used, ect was hardly performed to schizophernia patient or major depression. Nowadays when clozapine was famously used in treating schizophrenia, ect was performed more than before. The issue is why ect was performed more than before when clozapine was widely used as first line treatment. Does it because a more advanced era make the illness more advanced and more difficult to treat? Or maybe before no enough skillful health professionals can performed ect or maybe they dont like to perform ect to patient? Or is it because more depression nowsdays than few years back? However it is a issue because few years back, SSRI is widely used until recent, but why nowsdays SSRI made no diferent to certain patient and required ect to make them well.? This is a difficult to be answered. So does ect that bad? However a study need to be done locally to explore feeling of any patient that has gone on ect.
Other issue of ect is the patient still need to take continue medication after ect. Therefore what ect actually can do?
