Electroconvulsive Therapy - ECT

[Music] ect is electroconvertible therapy and as the name suggests it is a treatment treatment that is used to pass electricity which is turning electrical currents through the brain to the through the scalp to the brain to induce seizures which is therapeutic now this is done through under general anesthesia now today we will go through and discuss and see how ect is being done and how it is being carried out you're comfortable now this is the ect machine this is the machine that you're going to use to to to bring electric occurrence to the patient and as you can see these are the recordings we have already set for this specific patient now ect was introduced by two people they're italians there's one an italian psychiatrist who is known as luciobini and another one is an italian neurologist known as ogo kaliti now these two are the people who introduced uh ect that we now use and the modern is it is so much better than the ect that we used to see before whatever do we mean by that the uh the visit that was done before it was done without any anesthesia meaning a patient would even almost break their limbs or even have seizures that will make them bite that time but now the good thing about modern ect by using general anesthesia which will calm the patient the muscle will relax at the same time so the patient will feel much better and the patient is generally sleeping generally unconscious most of the time [Music] one in severe depression that is can be either unipolar or bipolar 2 in treatment resistance depression this refers to depression that has shown no improvement after different trials of medications and psychotherapy three in severe ammonia for catatonia this is a neurological condition in which the patient experiences extreme immobility or motor excitement both of which can be life threatening last but not the least schizophrenia and other psychotic illnesses my name is anaesthetist uh my role in ect treatment in psychiatric patients is basically to ensure safety of the patients during the procedure one before the patient is scheduled for the procedure we basically do lab investigations we check whether [Music] they are within normal range and we ensure the patient has a consent for the procedure and psychiatric patients normally cannot sometimes sign for themselves we seek consent from the relatives or the next of kin or their guidance and once we consent then we go ahead with the procedure we also inquire whether they have any other core mobilities illnesses that can interfere with the anastasia administration and if they have any we ensure that they are stabilized and they are taking their drugs correctly and the conditions have been controlled in a way that they are near normal [Music] normal functioning of the body and once they all that is within normal we go ahead with the procedure for patients to undergo a sitting procedure there are failures and preparations that need to be done before the procedure one you need to ensure that there is an informed concept signed by the relatives for the patient to understand the ect procedure also you need to ensure that some tests are done and like usc's you have lfts as well as the full immobile for the patient to undergo the ect you also need you also need to ensure that you have uh you staff the patient from midnight that's at least eight hours prior the ect procedure and you also need to ensure that you take the vital signs that is the blood pressure temperature weight as well as the pulse rate for the patient preparation for the ect procedure you also need to ensure that the lines have been fixed and also the communication are well prepared for pc procedure at the ect room we ensure that our patient monitors are working we ensure that we have oxygen and all the drugs that we use for anesthesia are available we ensure that the emergency drugs are there and during the procedure the role of anesthetist is to do to administer the anesthesia then monitor the patients during the procedure and until reversal from anesthesia and the anesthetist ensures that the patient is fully awake before they are transferred to the recovery room where the patient is handed over to the nurse in charge of the recovery [Music] room now as you can see the patient is now sedated the necessities has given me the go ahead to start now these are the electro electrodes that i'll put and i'll go to the scalp and i'll press it and after three seconds we'll be able to see what is going to happen so you can observe and you will see twitching of the foot now that is the twitching of the foot and that will and that means that the electrical impulses have gone through the patient and you have achieved a seizure [Music] now as you've seen seizures now we've seen the twitching of the foot now i will let the anaesthetist reverse the patient the patient will be reversed will be taken back to the recovery room and recovering the patient will just be there for a few minutes as you can see this is a very short procedure now after the recovery room the mitral signs will be checked and if they are stable and the patient will be stable the patient now will walk back to the world just like the patient wrote to the procedure so it is better as compared to the previous ect now is it is usually done so there are several indications for ect one is a patient that you've treated and treated and treated severally for depression but you're generally not seeing any improvement so we usually call it treatment resistant depression so treatment resistant depression would work best if you're giving ect then later on introduce the anti-depressant so these are the patients we see improving so much better with ect the other thing is you have a pregnant lady who is depressed but you want you you want to give them medication but you're worried about the fetus so easy takeover is the first line treatment for such patients so we do ect on a pregnant woman who is depressed we also do ect on a patient who is psychotic and has just delivered or is almost delivering or is doing almost delivering or just delivered so ect also works best for them now ectv work under is a multi-disciplinary we work on a multi-disciplinary team and what do you mean by a multidisciplinary team we have the anesthetist with available we have consultant psychiatrist who does the ect herself for himself we also have clinicians and we also have psychiatric nurses who do the vital signs and all the way facilitate the patient before recovery and after recovery so we work as a team generally [Music] after the ect procedure has been done the patient is taken to the recovery room whereby you come and observe the vital signs normally it takes around 10 to 15 minutes for the patient to be fully awake once the patient is fully awake and you normally take the patient as the world has to continue with [Music] managing [Music] the side defense of the risk factors of an intercontract therapy are not serious and are very rare they usually occur under the procedure whereby the patient can experience a migraine nausea temporary memory loss and sometimes confusions now the benefits of ects are meaning and we can say that 60 to 90 percent of patients we have seen they have improved the quality of life so we are seeing a great change with ect and also patients who have suicidal especially the patients who are depressed and they feel like they've lost hope and they want to commit suicide these are the best patients to start with ect as the first line mode of treatment we also have patients who are coming they don't want to eat they don't want to take any medications they're feeling extremely low or they're catatonic they generally don't move on to move or they're just there generally so if you do actually on these patients as the first line of treatment we have seen a great improvement in these patients we can say that ect is a very good treatment and can be used even as a first line of treatment as compared to certain medications and then changing to ect

Channel: Lifebridge Hospital

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Id: Ux49viMWsv0

Length: 10min 54sec (654 seconds)

Published: Sun Mar 07 2021