2. Certain types of schizophrenia that are less responsive to pharmacologic treatment.
3. Acute Manic Episodes- ECT is used for clients who have bipolar disorder with rapid cycling and very destructive behavior. Both of these respond poorly to lithium therapy so they have ECT and lithium therapy.
A. Recent myocardial infarction
B. History of cerebrovascular accident
C. Cerebrovascular malformation
D. Intracranial mass lesion.
2. Chemical dependence
3. Personality disorders
4. Situational depression
Any meds that affect the client’s seizure threshold must be decreased or discontinued several days before the ECT procedure.
MAOIs and lithium should be discontinued 2 weeks before the ECT procedure.
A short period of hypertension occurs immediately after the ECT procedure.
30 minutes prior to the beginning of the procedure, an IM injection of atropine sulfate or robinul (Glycopyrrolate) is given to decrease secretions and counteract any vagal stimulation.
A bite guard should be used to prevent trauma to the oral cavity.
Electrodes are applied to the scalp.
Short-acting anesthetic is given then a muscle relaxant.
The electrical stimulus is typically applied for 0.2 to 0.8 seconds. Seizure activity is monitored, and the duration of the seizure, which is usually 25 to 60 seconds, is documented.
Orient client frequently.
2. Reactions to Anesthesia
3. ECG changes- A client’s baseline heart rate is expected to increase 25% during the procedure and early recovery,
4. Headache, muscle soreness, and nausea.