Electroconvulsive therapy workbook : Clinical applications.

By: WEISS, ALAN
Material type: TextTextPublisher: London : Routledge, 2018Description: xx, 437 pages : illustrations ; 26 cmContent type: text Media type: unmediated Carrier type: volumeISBN: 1138713376; 9781138713376 (paperback)Subject(s): Electroconvulsive TherapyDDC classification: 616.89122
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Contents: 1.Introduction -- 1.1.Overview -- Purpose -- Aims -- Objectives -- A Competency-Based ECT Programme -- 1.2.Definition -- 1.3.Equipment -- History: ECT devices -- ECT device characteristics -- 2.Knowledge -- 2.1.History: treatment of mental illness -- Trepanning: early psychosurgery? -- Bloodletting -- Pharmacology -- Phrenology -- Early 1800s -- Electricity -- 2.2.History: ECT -- Mental illness and convulsions -- Negative images emerge -- The media fans negativity -- Unmodified ECT -- The changing face of the media -- The Bolam test -- 2.3.Major advances in ECT practice -- Introduction of anaesthesia -- Induction agents -- Muscle relaxants -- Hyperoxygenation and hyperventilation -- Electrode placement -- Ultrabrief ECT -- Stimulus wave forms -- Seizure threshold and stimulus dose titration -- Electroencephalogram (EEG) -- ECT: minimum standards and audit -- The lived experience -- 2.4.Mechanism of action -- Psychological hypothesis --

Contents note continued: Electrophysiological hypothesis -- Neuroendocrine hypothesis -- Neurochemical hypotheses -- Anticonvulsive hypothesis -- Neurogenesis hypothesis -- Gene expression hypothesis -- Cognitive effects of ECT -- 2.5.Clinical indications for ECT: adults -- Major depressive disorder/unipolar depression -- Clinical practice guidelines (CPGs) -- United Kingdom (UK) -- Scotland -- Spain -- World Federation of Societies of Biological Psychiatry (WFSBP) -- USA -- Canada -- Australia -- Bipolar disorder: mania, depression and mixed state -- Clinical practice guidelines (CPGs) -- United Kingdom (UK) -- USA -- World Federation of Societies of Biological Psychiatry (WFSBP) -- Scotland -- Canada -- Australia -- Schizophrenia -- Clinical practice guidelines (CPGs) -- Schizoaffective disorder -- Catatonia -- Neuroleptic malignant syndrome -- Perinatal disorders -- Parkinson's disease -- Other diagnoses -- 2.6.Clinical indications: children and adolescents -- History --

Contents note continued: Clinical concerns -- Clinical indications -- Major depressive disorder with melancholia and psychosis -- Major depressive disorder with lethal suicide attempts/severe self-injurious behaviour (SIB) -- Treatment-resistant depression and bipolar disorder in adolescents -- Bipolar disorder unresponsive to mood stabilisers -- Schizophrenia spectrum disorders (SSD) -- Catatonia in children and adolescents -- Tolerability of ECT in adolescents -- Special considerations -- 2.7.Clinical indications: older people -- Clinical concerns -- Clinical indications -- Tolerability of ECT in old age -- Management special considerations -- 2.8.Efficacy of ECT -- 2.9.Contraindications for ECT -- Mortality rate -- Complex comorbidities -- Cardiovascular risk -- Risk of untreated psychiatric illness -- Chemotherapy -- Conclusion -- 2.10.Brain stimulation: new directions -- Definition -- Advantages of brain stimulation techniques -- Convulsive stimulation techniques --

Contents note continued: Magnetic seizure therapy (MST) -- Focal electrically assisted seizure therapy (FEAST) -- Non-convulsive stimulation techniques -- Repetitive transcranial magnetic stimulation (rTMS) -- History of rTMS -- Resting motor threshold -- Patient set-up -- Safety -- rTMS stimulus parameters -- Factors that affect efficacy of rTMS -- rTMS in depression -- iTMS in schizophrenia -- rTMS as a clinical treatment option -- RANZCP Position Statement 79: rTMS (RANZCP, 2013) -- Deep repetitive transcranial magnetic stimulation (dTMS) -- dTMS safety data -- dTMS In psychiatric conditions -- dTMS in other conditions -- Transcranial direct current stimulation (tDCS) -- Patient set-up -- Other forms of transcranial electrical stimulation -- Evidence base for tDCS -- Vestibular stimulation -- Caloric vestibular stimulation (CVS) -- Galvanic vestibular stimulation (GVS) -- Evoked potentials (EP) -- Sensory evoked potentials -- Visual evoked potentials (VEPs) --

Contents note continued: Short-latency brainstem auditory evoked potentials (BAE Ps) -- Somatosensory evoked potentials (SEPs) -- Motor evoked potentials -- Transcranial electrical motor evoked potential monitoring (TCeM EP) -- Surgically invasive techniques -- Deep brain stimulation (DBS) -- DBS and Parkinson's disease -- DBS and depression -- DBS and obsessive compulsive disorder (OCD) -- Vagus nerve stimulation (VNS) -- VNS and intractable epilepsy -- VNS and treatment-resistant depression -- Transcutaneous vagus nerve stimulation (t-VNS) -- Direct cortical stimulation (DCS) -- Navigated repetitive TMS (nTMS) -- Pre-surgical functional magnetic resonance imaging (fMRI) for language assessment -- Magnetoencephalography (MEG) -- Conclusion -- 3.Organisational/administrative skills -- 3.1.Setting up an ECT service/clinical governance -- Approach to service delivery -- ECT service goals -- Communication -- ECT committee -- ECT clinical guidelines -- Database -- ECT team --

Contents note continued: Team members -- Clinical director of ECT services -- Psychiatry registrars/trainees -- ECT coordinator/nurse specialist -- Other team members -- Legislative framework -- Consent -- Equipment -- Environment -- General hospital -- Stand-alone ECT suite -- Initial assessment -- ECT technique -- Anaesthetic technique -- Anaesthetic agents -- Continuation and maintenance ECT -- Audit -- The lived experience -- 4.Clinical skills -- 4.1.The sequence of ECT -- Referral -- Emergency ECT -- The ECT journey -- Measurement during ECT -- Memory -- Audit -- ECT tapering/step-down -- ECT record -- 4.2.Adverse events of ECT -- Adverse events during ECT -- Cardiovascular events -- Asystole/electrocarcliac pause -- Oral and dental trauma -- Fractures -- Complications secondary to medication -- Prolonged seizures -- Adverse events immediately post-ECT treatment -- Transient postictal delirium -- Headaches -- Myalgia -- Nausea and vomiting --

Contents note continued: Adverse effects after the course of ECT treatment -- Cognitive disturbance -- Acute effects -- Retrograde amnesia -- Current debate: evaluating autobiographical memory -- Conclusion -- Anterograde amnesia -- Subjective memory deficits -- Fear of ECT -- Other cognitive deficits -- Detection of cognitive deficits -- Audio Recorded Cognitive Screen (ARCS) -- Strategies to improve efficacy and minimise cognitive impairment -- 4.3.Medical risks and management -- Cardiovascular complications -- Pathophysiology -- Clinical application -- High-risk cardiovascular conditions -- Management of the haemodynamic risk -- Myocardial infarction (MI) and unstable angina -- Cardiac pacemakers -- Aneurysms -- Neurological disorders -- Cerebral infarction and haemorrhage -- Intracranial pathology -- Epilepsy -- Multiple sclerosis -- Myasthenia gravis -- Skull defects and intracranial metal objects -- Neuropsychiatry disorders -- Dementia --

Contents note continued: Pseudodementia/depressive dementia -- Neuroleptic malignant syndrome (NMS) -- Parkinson's disease (PD) -- Muscular skeletal disorders -- Endocrine -- Osteoporosis -- Diabetes mellitus -- Hypothalamic--pituitary--thyroid axis -- Hyperthyroidism -- Hypothyroidism -- Chronic adrenal insufficiency (Addison's disease) -- Other endocrine conditions -- Metabolic disorders -- Hyperkalemia -- Hypokalemia -- Hyponatremia -- Hypernatremia -- Renal dialysis -- Other medical illnesses -- Eye pathology -- Obesity -- Dentition -- Chronic obstructive pulmonary disease and asthma -- Gastro-oesophageal reflux disease (GORD) -- Urinary retention -- Anticoagulation -- Pseudocholinestase deficiency -- Pregnancy -- Anaesthetic considerations -- Procedural modifications -- Postnatal considerations -- Breastfeeding -- 4.4.Drug interactions -- Antidepressants -- Tricyclic antidepressants (TCA) -- Selective serotonin/noradrenaline reuptake inhibitors (SSRI and SNRI) --

Contents note continued: Noradrenaline reuptake inhibitors -- Agomelatine -- Trazodone -- Monoamine oxidase inhibitors (MAOI) -- Bupropion (Zyban) -- Benzodiazepines -- Antipsychotic medication -- Clozapine -- Mood stabilisers -- Anticonvulsant medication -- Lamotrigine -- Anticonvulsants and epilepsy -- Lithium -- Other drugs -- Caffeine -- Theophylline -- Antihypertensive agents -- Digoxin -- Diabetic medication -- Acetylcholinesterase inhibitors -- Australian psychotropic therapeutic guidelines -- 4.5.Tips for clinical practice -- Background -- Stigma or no stigma? -- To talk or not to talk? -- Operating theatre or stand-alone suite? -- To titrate or not to titrate? -- To clean or not to clean? -- Disposable or handheld electrodes? -- To monitor or not to monitor? -- Electromyogram (EMG) -- Cuff monitoring -- Awareness -- Electrocardiogram (ECG) -- Deep tendon knee reflex -- Nerve stimulator -- To measure or not to measure? -- Ultrabrief or not ultrabrief? --

Contents note continued: What next after ultrabrief? -- Twice a week or three times a week? -- To restrain or not to restrain? -- Before ECT -- After ECT -- To time or not to time? -- To treat or not to treat? -- To continue or not to continue? -- Which device: MECTA or Thymatron? -- Conclusion -- 5.Technical skills -- 5.1.ECT technique -- Basic steps -- Isolated limb technique (ILT) -- Treatment steps -- Monitoring electrodes anatomical placement -- Thymatron System IV -- Placement of electrodes -- Electrode site skin preparation -- Apply treatment electrodes -- Testing impedance -- Thymatron System IV -- MECTA spectrum 5000 -- Oxygenation/hyperventilation -- Protection of the oral cavity -- Time out -- Anaesthetic technique -- Administration of anaesthetic agents -- Delivery of stimulus -- Thymatron System IV -- MECTA spECTrum 5000 -- Procedure post-seizure -- Recovery -- Missed or abortive seizures -- Missed seizures -- Abortive seizures -- 5.2.Electrode placement --

Contents note continued: History -- Current practice -- Ultrabrief ECT -- Landmarks -- Right unilateral ECT non-dominant (RUL) -- "Handedness" or laterality -- Left unilateral electrode placement (LUL) -- Bitemporal ECT (BT) -- Bifrontal ECT (BF) -- Left anterior right temporal (LART)/left frontal right temporal (LFRT) ECT -- Other electrode placements -- Recommendations for clinical practice -- Unipolar and bipolar depression -- Schizophrenia -- 5.3.Stimulus dosing strategies -- Current debate concerning dosing strategies -- Fixed high-dose strategy -- The evidence -- Age-based dose strategy -- Half-age dose strategy -- Stimulus dose titration -- Changing the stimulus dose -- Dose based upon multiple factors -- Benchmark method -- Other methods -- 5.4.The stimulus -- Stimulus parameters -- The ECT electrical circuit -- Impedance -- Charge -- Energy -- Charge-rate -- The action potential -- Inappropriate stimuli -- Constant current -- Wave form -- Pulse width -- History --

Contents note continued: Current practice -- Inter-pulse interval -- Stimulus train -- Frequency -- Amplitude -- Stimulus close -- Seizure threshold -- EEG "therapeutic window" -- Stimulus dose titration -- Combined titration and treatment -- Subconvulsive stimulation -- Cardiovascular disease -- Cognitive impairment -- 5.5.The electroencephalogram (EEG) -- Overview -- Definition -- Physiology -- Categorisation of bandwidths -- EEG properties -- Gain -- Workbook EEG traces -- Phases of the ictal EEG -- The ictal line -- Electrocardiogram (ECG) -- Measurement of the motor fit -- Summary -- Markers of seizure adequacy -- MECTA spECTrum 5000 -- Thymatron System IV -- The future -- EEG artefacts -- Conclusion -- 5.6.Anaesthesia for ECT -- Anaesthetic technique -- Anaesthetic agents -- Anticholinergic agents -- Induction agents -- Barbiturates -- Propofol -- Opioids -- Ketamine -- Etomidate -- Sevoflurane -- Muscle relaxants -- Suxamethonium or succinylclioline --

Contents note continued: Non-depolarising muscle relaxants -- Equipment -- Day-only procedures -- Recovery -- Hyperoxygenation -- Mouth protection -- Bite blocks -- Disposable/single-use bite blocks -- Re-useable/rubber bite blocks -- 5.7.ECT devices: set-up procedure -- Thymatron System IV -- For power settings above 100% without ultrabrief poise width (0.3 ms) modification -- Safety monitor activated alarm -- For power settings above 100% with ultrabrief pulse width (0.3 ms) modification -- MECTA spECTrum 5000M and Q -- Thymatron DGx -- 6.Ambulatory ECT, continuation ECT and maintenance ECT -- 6.1.ECT After Completion of the Index Course -- Ambulatory ECT -- Patient monitoring -- Tapering or step-down ECT -- Continuation ECT -- Maintenance ECT -- Indications for continuation and maintenance ECT -- Current state of the evidence -- The literature -- Maintenance ECT schedule -- The end point for maintenance ECT -- Physical assessment -- Cognitive assessment -- Case conference --

Contents note continued: Day of treatment -- 7.The ECT nurse and the ECT coordinator -- 7.1.Nurses: key members of the ECT team -- Nursing involvement in the ECT journey -- ECT ward nurse -- ECT admissions nurse -- ECT recovery nurse -- ECT nurse -- ECT coordinator -- 8.ECT: the lived experience -- 8.1.Consumer perspectives -- Wow I have my life back! By Alirra -- 9.Scenario-based problems -- 9.1.Postictal delirium and ECT -- 9.2.ECT, the elderly and a high seizure threshold -- 9.3.ECT, epilepsy and obsessional personality style -- 9.4.Fear of ECT -- 9.5.Complex ECT treatment: identify errors and make recommendations for improvement -- 9.6.EEG challenges: what should you do next? -- Case 1 19-year-old female, suprathreshold seizure -- Case 2 42-year-old male, threshold seizure -- Case 3 84-year-old female, poor-quality EEG -- Case 4 36-year-old female, fifth treatment with short EEG.

Item type Current library Shelving location Call number Status Date due Barcode Item holds
Text Text South West Healthcare
Library 616.89122 WEI 2018 (Browse shelf (Opens below)) Available 100014473
Text Text South West Healthcare
Mental Health Services - Acute Inpatient Unit 616.89122 WEI 2018 (Browse shelf (Opens below)) Not For Loan 100013705
Total holds: 0

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