SME: Medical Director
Last Review Date: 5/19/08
Physicians advise the patient of alternative treatment plans and inform him/her
of the consequences of treatment options in order to meet his/her individual
needs.
After notifying the UTHCPC Medical Staff Coordinator, the attending physician refers the patient who might benefit from ECT to contracted outside board certified psychiatrists privileged to perform ECT at accredited, contracted health care facilities.
The privileged outside physician does the following:
 | Reviews the referred patient's medical record |
| Examines the patient |
| Discusses his findings and recommendations with the attending physician |
| If the outside privileged physician prescribes ECT, she/he obtains the patient's consent according to Texas law and the policies and procedures pertaining to ECT within the contracted facility |
| Enters a note on the UTHCPC patient record/consult sheet summarizing findings and recommendations |
The attending physician may recommend ECT for an adolescent patient over 16 years of age and an adult patient when they have the following diagnoses:
| Major depression with imminent suicidal risk, or risk of dehydration, starvation or other physical harm due to medical conditions, delusions, resistant to pharmacologic intervention, and/or contraindication to psychoactive medications |
| Bipolar disorder-manic depressed or mixed with imminent suicidal risk, delusions, overexcitement, exhaustion, resistant to pharmacologic intervention, and/or contraindication to psychoactive medication |
| Schizophrenia, catatonic type, with a prominent affective component, or which has shown favorable response to ECT before |
| Other catatonic states of varying etiologies |
| Usual ECT treated disorders where intolerance or resistance to pharmacotherapy is present and continuation/maintenance of ECT is needed to sustain acute improvement. |
The attending physician considers ECT the primary treatment in the following situations:
| A need for rapid, definitive response on either medical or psychiatric grounds exists. |
| The risks of other treatments outweigh the risk of ECT. |
| A history of poor medication response and/or good ECT response with a previous episode of illness exists. |
| A patient prefers ECT rather than other alternatives. |
Follow these steps to properly schedule ECT treatments:
Step |
Action |
1 |
Doctor's orders are written for ECT treatment at least 24 hours before the day of treatment. The patient must be NPO before treatment beginning at midnight. ECT treatments ordered for patients at UTHCPC are considered out-patient treatment which are administered at the designated hospital. |
2 |
The attending physician discusses and schedules ECT treatments. The attending physician or designee writes the orders for the ECT treatment the day prior to the treatment. |
3 |
Nursing staff arranges transportation the day prior to the ECT treatment, taking into consideration that the patient needs to arrive at the hospital at least 30 minutes prior to the scheduled treatment time. |
4 |
Nursing staff accompanies the patient to the hospital, escorting staff remains with the patient. |
5 |
The staff member notifies the Escort Service at UTHCPC for transportation back to the hospital. |
The Joint Commission : Provision of Care, Medical Staff
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