ELECTROCONVULSIVE THERAPY (ECT) | RS JIWA PROVINSI JAWA BARAT

Summary

This video provides an in-depth explanation of Electroconvulsive Therapy (ECT), also known as SMP, used in treating severe mental health disorders like depression, catatonia, and aggression in dementia patients. The video details the procedure, indications, contraindications, side effects, preparation, and post-treatment care. ECT is presented as a critical therapy for patients who do not respond to medication, although it carries risks like memory loss, confusion, and heart issues. It emphasizes the importance of proper preparation and follow-up care to ensure patient safety and effectiveness of the treatment.

Takeaways

• 😀 Electroconvulsive Therapy (ECT) is used to treat severe mental health disorders that do not improve with medication.
• 😀 ECT works by using electrical currents to trigger seizures in patients, which can affect the brain's chemical structure.
• 😀 Indications for ECT include severe depression, chronic depression, catatonia, and aggression in dementia patients.
• 😀 ECT is considered when medication therapy has not shown improvement or when it is no longer effective.
• 😀 ECT has certain contraindications, such as brain tumors, recent heart attacks, osteoporosis, and other severe medical conditions.
• 😀 Common side effects of ECT include confusion, memory loss (retrograde amnesia), muscle aches, headaches, and dehydration.
• 😀 ECT can cause serious heart-related issues, including increased heart rate and blood pressure during treatment.
• 😀 Prior to ECT, patients must fast for at least 6 hours, undergo a pre-anesthesia examination, and have a complete medical history check.
• 😀 Laboratory tests such as blood work and EKG are essential, especially for patients over 60 years of age, to ensure safety during the procedure.
• 😀 The procedure involves placing electrodes on the patient's head to deliver electrical impulses, triggering tonic-clonic seizures for 15-120 seconds.
• 😀 Post-ECT care includes close monitoring of the patient's vital signs, oxygen levels, and orientation, with follow-up checks within 24 hours to observe for any side effects.

Q & A

What is Electroconvulsive Therapy (ECT) and how does it work?

Electroconvulsive Therapy (ECT), also known as Shock Therapy, is a medical treatment that involves applying electric currents to the brain to induce seizures. This process affects the chemical structure of the brain and is mainly used for patients with severe mental health disorders that do not respond to medication.

What mental health conditions can be treated with ECT?

ECT is indicated for severe cases of depression, chronic depression, catatonia, and aggression in dementia patients who are difficult to treat and exhibit behavioral changes.

Why is ECT used when medication doesn't work?

ECT is used when optimal medication treatment fails to show improvement. It is provided alongside medication and is discontinued once the desired therapeutic effects are achieved, or if there is no improvement after 10-15 treatments.

What are some contraindications for ECT?

Some contraindications for ECT include brain tumors, heart conditions like myocardial infarction, pulmonary tuberculosis, bone fractures, vascular issues, and diseases affecting the bones such as osteoporosis or osteomyelitis.

What are some of the risks and side effects of ECT?

ECT carries risks including anesthesia-related complications and physical effects like confusion, memory loss, jaw or muscle pain, headaches, nausea, vomiting, dehydration, and even serious heart issues due to elevated heart rate and blood pressure during the procedure.

How is a patient prepared for ECT?

Patients are required to fast for at least 6 hours before the procedure. Pre-anesthesia assessments should be conducted, especially for patients with high-risk conditions, and a complete medical history should be taken. A thorough physical examination, including assessments for heart disease, lung conditions, and neurological issues, is also necessary.

What are some of the medications that may affect the safety of ECT?

Medications that increase the risk of ECT include diuretics like furosemide, hypoglycemic drugs like glibenclamide, long-acting benzodiazepines like diazepam and clonazepam, lithium carbonate, antiepileptic drugs, and supplements containing magnesium.

What is the setup for conducting an ECT session?

ECT requires a dedicated room equipped with emergency tools such as an oxygen tank, suction devices, and an emergency phone. The patient should lie on their back, wearing loose clothing, with electrodes placed on the temples of the head to administer the treatment.

How is ECT administered and monitored during the procedure?

ECT is administered by placing electrodes on the patient's temples. The procedure induces tonic-clonic seizures within 5-10 seconds. The seizures should last 15-120 seconds. If they persist longer than 120 seconds, intervention is required. Vital signs, including heart rate, blood pressure, and oxygen saturation, are continuously monitored throughout the procedure.

What post-procedure care is required after ECT?

After ECT, patients are monitored in a recovery area for their breathing, pulse, blood pressure, and general orientation. Most side effects, such as confusion and memory loss, subside on their own without the need for further intervention. Patients are advised to limit physical activities post-treatment and follow up within 24 hours to check for any side effects.