Sections
Basic Components of the Evaluation | Decision About Whether to Administer ECT | Informed Consent | Management of Medications
Excerpt
Each pre-ECT evaluation should be carried out by an individual
clinically privileged to administer ECT in conjunction with an anesthesia
provider. This evaluation should include 1) a thorough psychiatric
history and examination, including history of response to ECT and
other treatments; 2) a medical history and examination, with special
attention paid to cardiovascular, respiratory, neurological, and
musculoskeletal systems; 3) a history of dental problems and examination for
loose or missing teeth; and 4) a history of personal and family
experiences with anesthesia (American Psychiatric Association 2001). Laboratory tests are generally performed, although
there is no agreed-on routine set of tests to carry out in each
case. The most commonly administered pre-ECT screening battery of tests
includes a complete blood count, serum chemistry (including sodium
and potassium), and electrocardiogram (American Psychiatric Association 2001). A chest radiograph is indicated in the
setting of cardiovascular or pulmonary disease or where there is
a history of smoking (American Psychiatric Association 2001; Weiner et al. 2000).