ECT Procedures

[ORNurseinNM]

Hello Everyone,

Just started at a new hospital that I really like. We do ECT procedures (Electroconvulsive Therapy,) probably about 5-8 cases per day. This is done only with anesthesia present (and the psychiatrist, obviously.) It is on our schedule because of the use of the anesthesia staff. I have never worked in an OR that performs these and I was wondering if this violates the 'RN as circulator' law that is in my state and many others. I have read up on the procedure and know it is short, but it is a procedure all the same. Does anyone else out there work in an OR that does ECT? If so, is there a circulator involved? Thanks in advance for the responses. Have a great week.

[Rose_Queen, BSN, MSN, RN]

We do not do ECT in my OR. In the facility where I did my clinicals, ECT was done in the PACU. We also have procedures involving anesthesia in the OR with the staff appropriate for the procedure (TEE, etc.). There isn't a circulator as these are not OR cases and the OR simply provides a space.

We do cardioversions and blood patches in PACU as well.

[elkpark]

I've seen ECT done in PACUs and also in designated rooms on psychiatric units. There was never a circulating nurse present; there was nothing to "circulate" for.

[azhiker96, BSN, RN]

We do ECTs in the PACU. We usually do 2 to 3 but we have done as many as 5 in a morning. A CRNA handles the anesthetic and paralytic. The psychologist attaches his leads and administers the shock. A PACU RN starts the IV, runs the timeout, assists with the procedure, and recovers the patient. Everything we might need is nearby.