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Phase 2 - Psych > ECT > Flashcards

Flashcards in ECT Deck (11)
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1
Q

What is ECT?

A

The passage of a small electrical current through the brain, sufficient to induce a seizure, that is considered to be therapeutic

2
Q

What is ECT used for?

A

Severe depressive illness
Uncontrolled mania
Catatonia

3
Q

What is catatonia?

A

State of immobility and behavioural abnormalities manifested by stupor

4
Q

What are the main groups of side effects which arise from ECT?

A

Memory issues
Risks of anaesthesia
Risks of ECT itself

5
Q

What side effects can arise as a result of the anaesthesia?

A
MI
Arrythmias
Aspiration pneumonia
Prolonged apnoea
Malignant hyperthermia
Muscle aches (due to suxamethonium)
Death (1 in 100,000)
6
Q

What side effects can arise from the ECT itself?

A
Confusion
Headache
Status epilepticus
Stroke
Arrythmias
Bleeding from ulcers
PE
Subconjunctival haemmorhage
Raised intraocular pressure
Broken teeth due to muscle clenching of masseter muscle
7
Q

What types of memory changes can arise from ECT?

A
Retrograde amnesia
Aterograde
Episodic (remembering specific events)
Somantic (meaning of words)
Procedural memory 
Geographical orientation
8
Q

What are some contraindications to ECT?

A
Raised intracranial pressure
Cerebran aneurysm 
Recent cerebrovascular event
MI within 3 months
DVT
K+ imbalance 
Uncontrolled HR or BP
Acute respiratory infection 
Recent food, fluids, chewing gum, cigarettes, sweets
Cochlear implants
Phaeochromocytoma
Unstable fractures 
Bariatric patients
9
Q

What are some conditions in which you must take caution when giving ECT?

A

Pregnancy - teratogenic effects in the first trimester
Controlled epilepsy
Pacemakers - can turn it off for the procedure

10
Q

What is the difference between bilateral and unilateral ECT?

A
Bilateral = 1 electrode over each hemisphere
Unilateral = 2 electrodes over the non-dominant hemisphere
11
Q

What are the differences between using bilateral and unilateral ECT?

A

Bilateral is effective, has a quicker action, is effective at threshold. Can give cognitive side effects and can be effective when unilateral ECT has failed

Unilateral - not effective at threshold, slower action, less cognitive side effects and is technically more difficult