Introduction of electroconvulsive therapy (ECT) 

Electroconvulsion therapy(ECT) is a medical procedure which is commonly used in treatment of severe depression or bipolar disorder. 

Electroconvulsion therapy (ECT) first introduced by cerletti and bini at 1938.

ECT is also known as the physical shock or electric shock therapy. 

    Defination of electroconvulsive therapy (ECT) 

    Artificial or grand mal seizures are produce by the electrode apply on temporal and between hemisphere of brain
    . 
    • Current average : 110V (90-150V) 
    • An 200 to 1600 milliampere

    • Duration : 0.1 to 1sec.
    • Frequency : 3time/week

    Criteria of ECT

    1. Painless
    2. Somatic therapy
    3. Electric current are use 
    4. Grand mal seizure are produce

    Indication of electroconvulsive therapy (ECT) 

    • Severe depression with suicidal tendency 
    • Sever psychosis
    • Some time use in mania

    Contraindication of electroconvulsive therapy (ECT) 

    • Increase ICP
    • MI or use of shunt and implant
    • Any metric device in body
    • Old age
    • Any nerve disease
    • Severe hypertension

    Complications of electroconvulsive therapy (ECT) 

    • Retrograde amnesia
    • Fracture
    • Joint disfunction
    • Breathing difficulty 
    • Headache
    • Confusion

    Use of medication during ECT

    1. Atropine sulphate
    2. Thiopentone:Na (Anesthesia) 
    3. Succinylcholine (muscle relaxant) 
    4. Pure O2 :before and after 

    Types of electroconvulsive therapy (ECT) 

    1.According to method

    According to method ECT are two types

    • Direct ECT: Direct ECT given with medication such as atropine sulphate.Drugs are administer before ECT. 

    • Indirect ECT: Indirect ECT given without medication and it is also known as modified ECT. 

    2.According to placement of electrode 

    According to placement of electrode there are three types

    • Unilateral: In unilateral ECT, Electrode are placed one side of head, commonly right side are used. 

    • Bilateral: In bilateral ECT, Electrode  are placed both side of head. 

    • Frontal:  Electrode are placed on frontal area. 

    Nursing responsibility before, during and after of ECT

    Nursing care Before the ECT:-

    • Advice to avoid smoking before before 24 hours. 
    • Maintain NPO for last 6 hours. 
    • Maintain TPR(Temprature, Pulse, Respiration). 
    • Remove jewellery and hand over family or hospital custody. 
    • Remove hair oil by the washing the hair with shampoo. 
    • Remove artificial teeth
    • Collect complete history related to implantation of any metallic device. 

    Nursing care during ECT:-

    • Reduce the anxiety level of the patient and relative. 
    • Transfer to well padded bed. 
    • Administer anesthesia and other pre ECT medication. 
    • Closely observe the patient after the administer of drugs. 
    • Use mouth gag. 
    • Support the shoulder, arm, thigh and hand with the soft pillow. 
    • Maintain TPR. 
    • Reverify of the patient. 
    • Give oxygen. 
    • Use of electrode with a gelly. 
    • Moniter level of consciousness. 


    Nursing care after ECT:-

    • Observe record vital sign. 
    • To prevent false avoid aspiration (provide side lying position). 
    • Moniter vital sign or level of consciousness every 15 minutes once stable. 
    • Reorient of the patient. 
    • After the consciousness provide clear fluid. 
    I hope  you like our article on electro convulsive therapy. Please watch above video on electro convulsive therapy to better understand.