ECT is given by our treatment team, consisting of an attending psychiatrist, an attending anesthesiologist, nurses, and technician assistants. The psychiatrists responsible for administering ECT are highly experienced specialists in this treatment. Each of the anesthesiologists is also highly experienced and is a member of the Department of Anesthesiology at Phelps. ECT is administered in PACU Area’s recovery room.
Before ECT is administered, the patient’s medical condition is carefully assessed. This includes a complete medical history, physical examinations, blood tests, urine tests, electrocardiogram (EKG), chest X-ray, and other tests, as indicated. An informed consent is obtained before the first treatment. You may have a third person present when consent is sought. If you lack capacity to consent the hospital Administrative Consent Guidelines regarding incapacitated individuals will be followed. The treatments are usually given 3 times per week — Monday, Wednesday and Friday mornings. The patient should not eat or drink anything after midnight prior to each scheduled treatment.
When the patient arrives, an intravenous line is started. Sensors for recording EEG (electrical measure of brain activity) are placed on the head. Other sensors are placed on the chest for monitoring EKG (electrocardiogram). A cuff is wrapped around an arm for monitoring blood pressure. When everything is connected and in order, a sleeping medication is injected through the intravenous line that will cause the patient to sleep for 5 to 10 minutes.
Once the patient falls asleep, a muscle relaxant is injected. This prevents movement, and during the seizure there are only minimal contractions of the muscles. When the patient is completely asleep and the muscles are well relaxed, the treatment is given. A brief electrical charge is applied to electrodes on the scalp. This stimulates the brain and produces the seizure that lasts for about a minute. If you were watching the procedure, you might notice that the toes wiggle, but little else. Throughout the procedure, the patient receives oxygen through a mask. This continues until the patient resumes breathing on his or her own. When the treatment is completed, the patient is monitored closely by trained nursing staff. Usually within 30 to 60 minutes, the patient can leave the recovery area.
ECT is given as a course of treatments. The total number needed to successfully treat psychiatric disturbance varies from patient to patient. For depression, the typical range is from 6 to 12 treatments, but some patients may require fewer and some patients may require more treatments.