What is electroconvulsive therapy?

Electroconvulsive therapy is actually a treatment method that uses alternating current or pulsed electricity. Currently, electroconvulsive therapy can be applied to a variety of diseases, such as common menopausal depression, bipolar disorder, schizophrenia and suicide attempts. Electroconvulsive therapy needs to be performed in a regular hospital, because the machines used are regular and professional, and the current generated is acceptable to the human body. Most patients who undergo electroconvulsive therapy will stop breathing, so doctors will also work to restore spontaneous breathing.

Methods and content

1. The patient lies supine on the treatment table with his limbs naturally stretched out. Sand bags are placed between the two shoulder blades, which is equivalent to the 4th to 8th thoracic vertebrae, to prevent spinal compression fractures during treatment.

2. Two assistants stand on both sides of the patient and apply appropriate pressure to the shoulder, elbow, hip, and knee joints to prevent dislocation, fracture, and soft tissue injury.

3. The doctor stands on the right side of the patient's head, places a double-layer tongue depressor wrapped with several layers of gauze between the upper and lower molars on one side of the patient, and asks the patient to bite tightly. Hold the tongue depressor with the thumb and index finger of your right hand, and use the other three fingers and palm to fix the patient's lower jaw. Use your left hand to press the back of your head, and apply force in the same direction as your right hand, which is holding your jaw, to stabilize your head. If the patient is uncooperative and unwilling to open his mouth, you can put the tongue depressor aside and use your right hand to protect his lower jaw as described above. When the child opens his mouth due to a convulsion, quickly insert the dental pad, but be careful to avoid biting the tip of the tongue and lips.

4. Place two electrodes coated with conductive gel or saline on the patient's temples. After all the above preparations are ready, the physician can start the electric treatment. AC twitching machines generally use a voltage of 90 to 120V, and the power-on time is 0.3 to 0.6s; pulse electric twitching machines generally use a power of 40 to 60mA, and the power-on time is 1 to 2s. If an AC convulsion machine is used and one application of power fails to induce a convulsion, the power-on time can be extended and the treatment can be continued after the patient's breathing has recovered. If it is still unsuccessful, the power can be increased and the power-on time can be extended for a third power-on treatment. To induce systemic convulsions as an effective treatment. In each treatment, the power should not be applied more than 3 times.

5. Before the convulsion stops but breathing has not yet resumed, turn the patient's head to the side to facilitate saliva flow out; at the same time, perform artificial respiration to help restore spontaneous breathing.

6. For those with slow breathing recovery and severe cyanosis, it is mostly due to the retraction of the tongue root blocking the airway. You can use a mouth opener to open the mouth, insert the tongue depressor into the pharyngeal cavity, press the retracted tongue root forward, and the breathing obstruction may be relieved immediately. If it is central respiratory depression, oxygen inhalation, artificial respiration and injection of nikethamide or lobeline should be given.

7. If mandibular dislocation occurs during treatment (the lower teeth are forward and the tongue depressor cannot be bitten tightly), the thumbs of both hands wrapped in several layers of gauze should be immediately extended into the patient's mouth and placed on the back of the lower teeth on both sides of the patient. The lower jaw should be pressed down evenly, and then pushed upward and backward with a little force to restore it to its original position. After reduction, quickly remove the thumb to prevent being bitten. You can also use the extraoral reduction method: first touch in front of the ears on both sides, and when you touch the condyle of the dislocated mandible, place the thumbs of both hands on top of the condyle, first press down hard, and then push upward and backward with a little force to reposition it. A clicking sound can be heard during reduction, and the lower teeth can be seen reduced.

8. After treatment and until consciousness is restored, care should be strengthened to prevent falls. If patients complain of dizziness or pain after treatment, the symptoms will gradually subside and no treatment is required. If the headache is severe and lasts for a long time, a careful neurological examination should be performed and symptomatic treatment should be given. When complaining of back pain, check for tenderness or percussion pain on the spinous processes of the spine, and take a spinal X-ray if necessary.