ECT involves the administration of electric current to the brain to induce a controlled seizure while the patient is under the influence of general anesthesia and muscle relaxants.
Preparation
The night before: You will be asked to consume no food or drink past midnight on the night before an ECT treatment. Please discuss with your treating physician whether you should take medications for high blood pressure, heart conditions, reflux, and other conditions on the morning prior to the treatments.
Getting there: To ensure your safety, our policy mandates that someone accompany you to ECT and stay for the duration of the treatment. You will not be allowed to transport yourself home on the day of ECT, so it is imperative that you have transportation arranged.
Meeting the team: Once you arrive at the treatment area, you will meet the members of the ECT team. The team typically consists of an attending psychiatrist, a psychiatry resident, an anesthesiologist, and nursing staff.
Treatment experience
The nursing staff will give you with a hospital gown and perform an initial assessment of your current condition (symptoms, side-effects and vital signs). The psychiatrist will perform a brief physical and mental status exam. This usually takes place in a pre-treatment waiting area.
Another member of the team will insert an intravenous (IV) catheter which will allow administration of medications and anesthetic agents necessary to perform the procedure. You will then be taken into the treatment room where you will be attached (via pads and wires) to various equipment to monitor your blood pressure, heart rate, blood oxygen level, and brain waves.
The anesthetic agent will be administered to put you to sleep for a short time. Simultaneously a mask to provide oxygen will be placed over your nose and mouth. Once you are under the influence of the anesthetic, a muscle relaxant will be administered. This is done to prevent your muscles from contracting during the seizure. This is a safety measure and prevents inadvertent injuries.
Two electrodes will be placed on your scalp and brief pulses of electricity will be given over a few seconds to induce the seizure. Seizure duration varies but typically a seizure lasts well under a minute. You will be unconscious during the electrical stimulation and seizure.
Your vital signs and brain wave activity will be monitored closely during the procedure. The entire procedure from the time of administration of anesthesia to you beginning to wake up will last around 15 minutes. Once you begin to wake up, you will be transferred to the recovery room. Typically, when patients awaken from the treatment they are momentarily confused. This confusion usually resolves within 30 minutes of awakening.
In the recovery room, your vital signs will continue to be monitored and the nursing staff will frequently check your level of consciousness. Once you have regained full consciousness and your vital signs are stable you will be allowed to leave the recovery area. You can expect to spend approximately half an hour recovering from the procedure.