Intravenous Ketamine to Facilitate Transport of Agitated Patients to the ECT Clinic.

IF 1.8 4区医学 Q3 BEHAVIORAL SCIENCES

Journal of Ect Pub Date : 2024-11-26 DOI:10.1097/YCT.0000000000001090

Olivia Dean, Anthony Byford-Brooks, Kara Hannigan, Danielle Saunders, William Gamble, George Kirov

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引用次数: 0

Abstract

Objectives: Electroconvulsive therapy (ECT) can be effective for a variety of psychiatric conditions, including for some patients who are very psychotic or agitated. Transferring such patients from the psychiatric ward to the ECT clinic can pose significant challenges for treating teams, as they try to minimize the use of restraint.

Methods: We developed a protocol for safe transfer of such patients using sedation with ketamine. An intravenous cannula is inserted on the ward in a low stimulus environment with gentle supportive holds. Intravenous ketamine is given in a bolus at 0.5-2.0 mg/kg. The patient is transported on a transfer bed to the ECT clinic within a few minutes, and usual ECT process is immediately followed.

Results: We describe 6 patients who were given between 1 and 11 ECT treatments using this method. All of them finished ECT courses without the need for ketamine sedation. Five of them regained capacity, provided informed consent for further ECTs, and eventually reached remission.

Conclusions: Ketamine can be used to manage risk and transfer agitated patients to an ECT clinic for treatment.

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静脉注射氯胺酮以方便将躁动不安的患者送往电痉挛治疗诊所。

目的：电休克疗法（ECT）可有效治疗多种精神疾病，包括一些精神错乱或躁动不安的患者。将这类患者从精神科病房转移到电休克治疗诊所可能会给治疗团队带来巨大挑战，因为他们要尽量减少约束手段的使用：方法：我们制定了使用氯胺酮镇静剂安全转移此类患者的方案。方法：我们制定了一套使用氯胺酮镇静剂安全转移此类病人的方案。静脉注射氯胺酮，剂量为 0.5-2.0 毫克/千克。患者在几分钟内被转运到电痉挛治疗诊所，并立即开始常规的电痉挛治疗过程：结果：我们描述了使用这种方法进行 1 至 11 次电疗的 6 名患者。所有患者都在无需氯胺酮镇静的情况下完成了电痉挛疗法疗程。其中五人恢复了行为能力，在知情同意的情况下接受了进一步的电痉挛疗法，最终病情得到缓解：氯胺酮可用于控制风险，并将情绪激动的患者转移到电痉挛疗法诊所接受治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ect 医学-行为科学

CiteScore

3.70

自引率

20.00%

发文量

154

审稿时长

6-12 weeks

期刊介绍： The Journal of ECT covers all aspects of contemporary electroconvulsive therapy, reporting on major clinical and research developments worldwide. Leading clinicians and researchers examine the effects of induced seizures on behavior and on organ systems; review important research results on the mode of induction, occurrence, and propagation of seizures; and explore the difficult sociological, ethical, and legal issues concerning the use of ECT.