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Ect guide Guideline The Administration of Electroconvulsive Therapy July CGuideline for the Administration of Electroconvulsive Therapy Published by the State of Queensland Queensland Health March This document is licensed under a Creative Commons Attribu

Guideline The Administration of Electroconvulsive Therapy July CGuideline for the Administration of Electroconvulsive Therapy Published by the State of Queensland Queensland Health March This document is licensed under a Creative Commons Attribution Australia licence To view a copy of this licence visit creativecommons org licenses by au ? State of Queensland Queensland Health You are free to copy communicate and adapt the work as long as you attribute the State of Queensland Queensland Health For more information contact Mental Health Alcohol and Other Drugs Branch Department of Health GPO Box Brisbane QLD email OCP-MHAODB health qld gov au phone An electronic version of this document is available at https www health qld gov au qhpolicy html index-m asp Disclaimer The content presented in this publication is distributed by the Queensland Government as an information source only The State of Queensland makes no statements representations or warranties about the accuracy completeness or reliability of any information contained in this publication The State of Queensland disclaims all responsibility and all liability including without limitation for liability in negligence for all expenses losses damages and costs you might incur as a result of the information being inaccurate or incomplete in any way and for any reason reliance was placed on such information The Administration of Electroconvulsive Therapy ii - CContents Purpose Background Scope Related documents Authorising Policies and Standards Procedures Guidelines and Protocols Forms and templates Terminology used in guiding documents Governance of the ECT service Role and membership of the ECT Management Committee Maintenance of equipment and supplies Sta ? training Consultant psychiatrists Registrars Other medical o ?cers Nursing sta ? Granting clinical privileges to perform ECT credentialing Responsibility for clinical privileging Initial clinical privileging process Ongoing clinical privileging ? ? ? ? ? ? ? ? Privileging of psychiatry registrars and other medical o ?cers Consent and legal issues ECT is a Regulated Treatment under the Mental Health Act Mental Health Review Tribunal Approval Emergency ECT Indications for ECT Risks of ECT Non-cognitive risks of ECT Cognitive risks of ECT Adverse incident or critical event ECT in special populations Children and adolescents Pregnancy The elderly Cultural considerations Medical considerations prior to ECT ??history physical examination and baseline cognitive testing Psychiatric examination Extended assessment The Administration of Electroconvulsive Therapy iii - C Investigations Consultation with other specialists Medications and ECT Cardiac pacemakers Implanted cardiac de ?brillators Cochlear implants Equipment and sta ?ng Location of ECT administration ECT equipment Anaesthetic and resuscitation equipment Sta ?ng of the ECT suite The ECT procedure Patient identi ?cation and procedure matching During the procedure Sign out ?? before the patient leaves the ECT suite Post ECT care Recovery Management of adverse e ?ects ? ? ? ? ? ? ? ? ? ? Post-ECT delirium Treating electrodes Electrode placement options Electrode placement recommendations Electrode placement ??positions Dosage Dosage increases during treatment Pulse width Frequency and spacing of treatments Number of treatments Determination of an adequate seizure Criteria for re-stimulation Prolonged seizures Titration technique Documentation Clinical monitoring