My Experience at ECT

Sunday, March 13, 2016

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Hey friends,

I am currently in my mental health rotation with the best professor ever!! Like literally she is amazing. Well, since she is so amazing she got our whole clinical group the chance to float to ECT procedures for the day. It was honestly one of my better clinical moments. I am not sure if it was the amazing nurses/techs that made the day wonderful, or if it was how neat the outcomes of ECT are for the patient. 

So for those of you who do not know, ECT stands for electroconvulsive therapy. The procedure is done under general anesthesia and small electric currents are passed through the brain to trigger a small seizure. Doctors and researchers do not completely understand how the process works, but it seems to change some chemistry in the brain that helps with symptoms of certain mental illnesses, mostly depression. There is no "set" regimen of treatment and it solely depends on the patient. There were some individuals that I met who go twice a week, whereas others only went once a week. And the amount of treatments you can receive is almost indefinite. One patient was receiving her one hundredth ECT procedure. 

So the way my clinical day worked was that there was 3 of us students in that wing. One of us would work with the RN and get patients from the waiting room, take them to the room, and start an IV. As we were doing that the other student was working with the tech (not sure of their credentials) hooking the patient up their chest leads, blood pressure cuff, SpO2 monitor, and the specific leads for the electric current. The remaining two people in the room where the anesthesiologist (who was a resident) and that doctor. The last student was in their PACU room. The patients were monitored for 15 minutes before moving to phase 2 where their vital signs were taken after 15 minutes and patients were encouraged to drink something. Overall, it is very fast paced.

I found that the PACU area was way more relaxed than the OR's PACU I have floated in before. The nurses were nice, but I felt like they might have been more concerned with cleaning beds and moving them to the next phase, then really make sure the patient is stable. Of course, nothing bad happened, so maybe they were just really good at multitasking. I'll be there one day. I am sure. 

But I absolutely loved not only working with the tech, but also the RN. Both men were so willing to teach us and the doctors even showed us the brain wave strips and described how you see the seizures. I loved that everyone treated us like this was their first day having a student and was so excited for it. 
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I was able to insert one IV. The other patients were hard sticks or had ports. I was also nervous to insert an IV because I get lightheaded when I do it. Not sure why, but it happens. Additionally, the RN let me push almost all the medications, except Succinylcholine. 

When I was working with the tech, I was able to hold the leads on the two temples as an electric current was sent. I could feel the patient tense up right before they had a seizure. And I should mention that these seizures are very subtle. The patient is not flopping around, but rather their toes wiggle. Some patient's arms would wiggle too, but nothing extreme. 

Overall it was a really great experience! I spoke with one patient about her experiences and she said it really helped. She was recently sick and took two weeks off and could notice how much more depressed she was. She did mention to me that the change does not happen rapidly, but rather you have to sort of "build up" the effects. 

What interesting things have you been able to experience in clinical?

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