1 / 10

Key changes to ECT

Key changes to ECT. Dr. Rafael Euba. Main Change 7. Electro-Convulsive Therapy. ECT – section 58a. Adults with capacity can refuse to accept ECT treatment even if they are detained under the Act

tryna
Download Presentation

Key changes to ECT

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Key changes to ECT Dr. Rafael Euba

  2. Main Change 7 Electro-Convulsive Therapy

  3. ECT – section 58a • Adults with capacity can refuse to accept ECT treatment even if they are detained under the Act • Where an adult lacks capacity, this assessment must be agreed by a SOAD who must also confirm that ECT would be appropriate • The SOAD must also confirm that there is no valid advance decision regarding ECT

  4. Section 62 – emergency treatment • Section 62 continues to allow ECT treatment in an emergency • However, clinicians will be expected to take account of the views expressed by patients with regard to ECT, and any Advance Decision they have made

  5. So • No ECT in the face of a refusal with capacity • ECT given under MHA in those who lack capacity and do not resist • Require second opinion for those under 18

  6. Special treatment status • Has special status under section 58 making it a special treatment under the MHA which requires consent or a second opinion

  7. Critique • We do not think we ever gave ECT to those who had the capacity to refuse it. A psychotic depression causes capacity to be compromised and if ECT is imposed, then that person lacked capacity • Good practice to write down your assessment in terms of a capacity assessment and record that and to continue reviewing capacity and consent during the course of treatment

  8. Update on ECT • Current dosing regime;- stimulus dosing, minimum charge for maximum effect • Monitor response and adjust according to response • Anaesthetic = propofol so shorter seizures

  9. Memory and reversible changes • Biographical memory impairment is reversible (within 3 months or so), but there is some evidence that for a minority of patients there may be some permanent changes. • Almost all resolves within 3 months

  10. How to do it • Good assessment • Use ECT pack • Rate severity of illness • Prescribing clinician share responsibility with the administering clinician • Done in an accredited centre

More Related