- My Impression: It looks a bit brutal to my eyes, too. as many laymen think/say.
- despite the fact: It is the most effective therapy to some refractory sever psychiatric diseases(eg. refractory depression, psyshosis, agression.) and also it is a routine therapy.(commonly done). There are many arguments againt this.
I could observe this interesting therapy twice.
- Monday, March 12th, 2018. 4 patients
- Wednesday, March 14th, 2018. 4 patients. (2 patients are the same above)
 ECT device |
 two electrodes |
The machine:
- yellow button for impedance masurement: to check the electrodes touch to the head of patient properly; if it is too high, it is not "connected" to the skull.
- Dial: for adjusting the dose. Maximum is 504mC(couron). 0%-100%. I saw younger pt with lower dose 15% (not effective, and increased to 25%: seisure occurs). Elder patients 100%. still does not effective.
- Red button: Shoot.
- Small screen: shows impedance. and also it counts up in sec, once you give the shock. It is used for counting the seconds how long the seizure lasts if it happens. eg. 24 secs.
- they say, it is effective if seizure lasts for longer than 20secs, and it is not if less.
- You put two electrodes on the surface of skull.
- Give an "electric shock" in your brain.
- which induces the convulsions.
- For the seizure to be effective, it should last for 20 seconds.
- It is performed in a room in a ward.
- Muscle relaxant is necessary. (succinyl-colin, depolarizing agent, lasts 10mins).
- Monitor vitals: BP (it may reach 180/100 after seizure), HR, RR.
- put general anesthesia. (propofol)
- The anesthesiologist said that the team is trained with resuscitation. Patient may become unstable, although it rearely happens.
- We can observe the convulsions by small muscle contraction(small tonic-clonic movements).
- Monday, March 12th, 2018.
There were 4 patients. But no patients has an effective seizure. One
patient has a convulsion but it lasts only 10 secs, thus it is not
long enough to be effective.
- refractory depression elderly. 4th time.
- agression: autism. young patient.
- patient with no diagnosis: elderly.
- (can not remember)
- Wednesday, March 14th, 2018.
There were 4 patients. 3 seizures happened. two are long enough, 22
and 24 seconds respectively. One was 17 seconds. The last one no convulsion.
- refractory depression elderly. (5th time, 100%)
- agression: autism. yound patient2. (2nd time, 15%, 2nd time 25%)
- schizoaffective. (2nd time, 100%)
- agression: autism. 3rd time. young patient. I saw this patient in the closed ward. he hit his head occasionally.