Topic:

Psychiatric and Mental Health Nursing

NUR 305

Academic Year: 2021

Semester: Summer

Student Names: Rawan Musa Khateeb

Academic Number: 18111007

Supervised by:

Mis. Amal Al Blowy

Date of submission: 24.6.2021 Time: 9:35pm

Al-Riyada College ‫كلية الريادة‬
For Health Sciences ‫للعلوم الصحية‬

Electroconvulsive therapy (ECT):

Formerly known as electroshock. Is a type of therapy in which electric currents are

passed through the brain, this can cause brief seizures and changes in brain chemistry. It is a
medical treatment most commonly used in patients with severe major depression or bipolar
disorder that has not responded to other treatments. But because it is an invasive procedure
and can cause some memory problems, ECT should be used only when absolutely necessary.
Involves a brief electrical stimulation of the brain while the patient is under anaesthesia.

It is typically administered by a team of trained medical professionals that includes a

psychiatrist, an anaesthesiologist, and a nurse or physician assistant.

Indications for use ECT:

ECT may be considered as a primary treatment (or first-line treatment) for persons
exhibiting syndromes such as:

 Severe depression, particularly when accompanied

by detachment from reality (psychosis), a desire to commit suicide or refusal to eat.

 Treatment-resistant depression, a severe

depression that doesn't improve with medications or other treatments.

 Severe mania, a state of intense euphoria, agitation

or hyperactivity that occurs as part of bipolar disorder. Other signs of mania include
impaired decision-making, impulsive or risky behavior, substance abuse, and psychosis.

 Catatonia, characterized by lack of movement, fast

or strange movements, lack of speech. It's associated with schizophrenia and certain
other psychiatric disorders. In some cases, catatonia is caused by a medical illness.

2
Al-Riyada College ‫كلية الريادة‬
For Health Sciences ‫للعلوم الصحية‬

 Schizophrenia, based on clinical observation that

persons with epilepsy and schizophrenia often had an improvement in symptom severity
following a spontaneous seizure.

Contraindications for use ECT:

 Increased intracranial pressure, including tumors, hematomas, and subarachnoid

hemorrhage.
 Acute myocardial infarction.
 Hypertension.
 Cardiac disease, aneurysm, thrombophlebitis, bleeding disorders or where there is
increased risk of embolism.
 cerebrovascular accident (CVA).
 Severe pulmonary disease, such as pneumonia and TB.

Adverse effect of ECT:

 Deaths during ECT are due to general anesthesia.

 Headache and body ache.
 Memory disturbance than bilateral ECTs.
 Confusion may occur in the postictal perial.
 Memory lost from a day or a month due to hypoxia of the brain.
 Thoracic spine or long bones fracture.
 Medical complications.

3
Al-Riyada College ‫كلية الريادة‬
For Health Sciences ‫للعلوم الصحية‬

Nurse roles & preparations before ECT procedure:

 Preparation of treatment suite for the ECT procedure.
 The patient’s identity is checked and the patient wears an identity bracelet.
 Ensure safekeeping of the patient’s valuables.
 NPO for minimum 4 hours before treatment to prevent possible aspiration during
anesthesia.
 The patient’s hair should be clean and dry to allow for electrode contact.
 Hairpins, bracelets, body piercing should be removed to avoid burns.
 The patient should be encouraged to pass urine before the treatment to avoid
incontinence during the procedure.

Nurse roles during ECT procedure:

 Transfer the patient on a trolley from the waiting room to the ECT room on a well-
padded bed and placed in a comfortable dorsal position or supine position. A small
pillow is placed under the lumber curve.
 Apply ECG electrodes, BP cuff, and pulse oximetry sensor (not on same extremity
as BP cuff).
 Support the shoulder and arms of the patient. Restraint the thigh with the help of a
sheet.
 Make the observations of the convulsions.
 Give a short acting anesthetic agent. Thiopental .25mg to .5 mg, IV and secoline
(succynyl choline) 30-50 mg. The dose of drug may vary from patient to patient.
 Administer oxygen.
 Restore respiration by giving O2 if necessary.

4
Al-Riyada College ‫كلية الريادة‬
For Health Sciences ‫للعلوم الصحية‬

References:

- What is Electroconvulsive therapy (ECT)? (n.d.). Retrieved from

https://www.psychiatry.org/patients-families/ect

- Electroconvulsive therapy (ECT). (2018, October 12). Retrieved from

https://www.mayoclinic.org/tests-procedures/electroconvulsive-therapy/about/pac-

20393894

- Office of Mental Health. (n.d.). Retrieved from

https://omh.ny.gov/omhweb/ect/clinical_indications.html

- ABA Keywords. (n.d.). Retrieved from

https://www.openanesthesia.org/ect_contraindications/

- Side effects of ECT. (2021). Retrieved 24 June 2021, from

https://www.mind.org.uk/information-support/drugs-and-

treatments/electroconvulsive-therapy-ect/side-effects-of-ect/

- Kavanagh A, McLoughlin DM. Electroconvulsive therapy and nursing care. Br J

Nurs. 2009;18(22):1370-7.

- Vera, M., By, -, Vera, M., & Matt Vera is a registered nurse with a bachelor of

science in nursing since 2009 and is currently working as a full-time writer and editor

for Nurseslabs. During his time as a student. (2014, February 04). Electroconvulsive

Therapy. Retrieved from https://nurseslabs.com/electroconvulsive-therapy-nursing-

care/