Convulsive-free electroconvulsive therapy (MECT) is one of the psychiatric treatments, and because of the differences in patient fitness, there are some unpredictable risks involved in the treatment, so the treating physician should perform a risk assessment before administering the treatment, which includes the following.
First.
Does the patient have a complete medical history?
Is the medical record detailed?
Is there a detailed psychiatric history, a complete physical examination?
Is it an indication for MECT?
Are there any contraindications to MECT?
Is there any past history of drug allergy, especially narcotic allergy?
What is the efficacy of previous MECT?
What is the patient’s cardiac function?
MECT will increase the cardiac load. MECT can be performed in cardiac function class I and II, but is contraindicated in class III and IV.
Is there any murmur on cardiac auscultation?
Is the patient conscious?
Are there any signs and symptoms of cerebral nerve damage?
Second.
Is there a complete laboratory examination?
Is the blood biochemical examination, blood potassium, etc. normal?
Is the liver function test, transaminases normal?
Is the kidney function normal?
Third, other examinations: Are the patient’s teeth loose? Is there a pacemaker?
Fourth, risk assessment: according to the patient’s physical condition, is the patient at great risk of anesthesia? Is the patient prone to respiratory depression, cardiac arrest, or tracheal reflux?
Fifth, comprehensive analysis of the patient’s condition to determine whether the patient should be treated with non-convulsive electroconvulsive therapy. If no convulsive electroconvulsive therapy can be performed, what are the reasons?
Sixth, in response to the risks that occur in the treatment of non-convulsive electroconvulsive therapy, continuously summarize the lessons learned and prepare for risk warning.