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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).

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