Course name : psychiatric nursing .

subject : ElectroConvulsion Therapy . by Name : mohammad shbaitah .

I D number : 200911524 .

Definiation Mechanism of action Placement Course Side effect Instruction Legally Nursing intervention

Electroconvulsive therapy (ECT) :

ECT is a treatment for a small number of severe mental illnesses. It was originally developed in the 1930s and was

used widely during the 1950s and 1960s for a variety of

conditions. It is now clear that ECT should only be used

in a smaller number of more serious conditions.

ECT consists of passing an electrical current through the

brain to produce an epileptic fit hence the name, electro-convulsive.

The aim of ECT is to induce a therapeutic clonic seizure

(a seizure where the person loses consciousness and has convulsions) lasting for at least 15 seconds. Although a large amount of research has been carried out, the exact mechanism of action of ECT remains elusive. ECT doctors claim it may "jumpstart the brain", helping boost neurotransmission

while others like Peter Breggin, claim it causes the

"euphoric" effects similar to the effects found in "closed head injury" or people with fresh traumatic brain injury. The main reasons for this are that the human brain can not be studied directly before and after ECT and therefore scientists rely on animal models of depression and ECT, with major limitations.

The seizure in the brain caused by ECT influences many

chemicals in the brain these chemicals called neurotransmitters deliver massages from one brain cell to another ECT,s effect on these chemicals can make the brain cells work better A person,s mood will improve when his or her brain cells and chemical messengers work better .

(Fink M. Electroshock revisited. American Scientist. March-April 2000.)

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 Index

course 6-8 Txs . 2-5 Txs per week . Tx until improvement plateaus . continuation/ maintenance ECT . Prophylactic medication .

About 70 percent of ECT patients are women. This is

almost entirely due to women being at twice the risk of

depression. Older and more affluent patients are also

more likely to receive ECT. The use of ECT is not as common in ethnic minorities.

Aside from effects in the brain, the general physical risks of ECT are similar to those of brief general anesthesia. the most common adverse effects are confusion and memory loss. Some patients experience muscle soreness after ECT. This is due to the muscle relaxants given during the procedure.

Common : transient confusion,

headache,nausea,myalgia,retrograde and

anterograde amnesia.

Uncommon: cardiac arrest,unstable arrhythmias,

ischemia, sever hypertention or hypotention , stroke

,prolonged apnea ,fractures ,hyperthermia.

 Increased
Unstable Recent Recent Retinal

ICP .

angina .

MI.

stroke.
detachment.

Informed consent: informed consent of the patient is important before ECT is administered "E.C.T should be administered only after obtaining informed consent.

this doctrine places a legal obligation on a doctor to make a patient aware of: the reason for treatment, the risks and benefits of a proposed treatment, the risks and benefits of alternative treatment, and the risks and benefits of receiving no treatment. The patient is then given the opportunity to accept or reject the treatment.

Void on call to ECT in AM . NPO after MN . Hold all current medications the of ECT except: Anti-HTN . Pulmonary {bronchodilators}. Glaucoma meds.

Giving consent to having ECT. Educate regarding ECT including the procedure & expected effect. Remove potential harmful objects {jewelry , dentures} . Check vital signs. Decrease anxiety . Maintain patient airway { mouth gag }

Epidemiologia e psichiatria sociale . Whitaker, Robert (2010) enduring mistreatment of the mentally ill . www.wikipedia.com.