Electroconvulsive therapy (ECT) is a biological treatment that consists of inducing a generalized seizure in the patient, in a controlled manner, by administering an electrical stimulus above the seizure threshold.
Today, its mechanism of action is not exactly known, but it has been proven that it provides numerous benefits in patients with mental disorders such as mania, depression, schizophrenia or Obsessive Compulsive Disorder (OCD). The process in which ECT is carried out can be divided into two phases:
Phase 1: Pre-electroconvulsive therapy (ECT)
This phase includes the activities carried out from the moment the doctor informs the patient of the need for therapy until the electrical impulse is administered. In this phase, the nurse must:
- Provide general information about ECT to the patient and their relatives.
- Perform an initial assessment of the patient.
- Carry out complementary tests.
- Prepare the patient for therapy.
- Preparation of all the necessary material.
- Provide psychological support to the patient.
- Control vital signs.
- Administer the medication prescribed by the doctor and/or the anesthetist.
- Put the patient in a mouth guard.
- Fix the lower jaw in cephalic hyperextension.
- Monitor the seizure.
Phase 2: Post ECT
This phase includes the activities carried out from the end of the electrical impulse until approximately four hours have passed. The nurse, in this phase of electroconvulsive therapy should:
- Administer oxygen with ambu.
- Remove the mouth guard.
- Put on an oxygen mask.
- Record all medication administered.
- Detect and act against possible complications and immediate and late side effects.
- Orient and provide safety to the patient.
- Check vital signs periodically.
- Transfer the patient to the Hospitalization Unit in the supine position and with the head incorporated at 30 to 45º.
- Restart the patient’s diet as tolerated.
With all this, it can be verified that the nursing professional has many important activities to carry out before, during and after this therapy, so that the result is the most beneficial for the patient and their families.