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    Ect Consent Form

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    Challa Krishna Vasan
    The document outlines the process and risks of electroconvulsive therapy (ECT). It explains that ECT is administered under anesthesia to avoid discomfort. Patients must fast in the morning of treatment. A small, safe dose of electricity is used to stimulate brain cells and induce a brief seizure. Side effects include temporary headache and confusion, and possible memory lapses around treatment days. Consent from the patient or their relative is required prior to treatment.

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    Ect Consent Form

    Uploaded by

    Challa Krishna Vasan
    63 views2 pages
    The document outlines the process and risks of electroconvulsive therapy (ECT). It explains that ECT is administered under anesthesia to avoid discomfort. Patients must fast in the morning of treatment. A small, safe dose of electricity is used to stimulate brain cells and induce a brief seizure. Side effects include temporary headache and confusion, and possible memory lapses around treatment days. Consent from the patient or their relative is required prior to treatment.

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    ECT consent form in management of MI

    Original Title

    ect consent form

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    The document outlines the process and risks of electroconvulsive therapy (ECT). It explains that ECT is administered under anesthesia to avoid discomfort. Patients must fast in the morning of treatment. A small, safe dose of electricity is used to stimulate brain cells and induce a brief seizure. Side effects include temporary headache and confusion, and possible memory lapses around treatment days. Consent from the patient or their relative is required prior to treatment.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    63 views2 pages

    Ect Consent Form

    Uploaded by

    Challa Krishna Vasan
    The document outlines the process and risks of electroconvulsive therapy (ECT). It explains that ECT is administered under anesthesia to avoid discomfort. Patients must fast in the morning of treatment. A small, safe dose of electricity is used to stimulate brain cells and induce a brief seizure. Side effects include temporary headache and confusion, and possible memory lapses around treatment days. Consent from the patient or their relative is required prior to treatment.

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    ECT ADMINISTRATION MANUAL 47

    APPENDIX-I
    ECT CONSENT FORM
    Information:
    After examination and considering all aspects of your condition we opine that
    you would require ECT as a form of treatment. The treatment is given under
    anesthesia so that you do not experience any discomfort. You will be required to
    be on empty stomach in the morning of ECT. The anesthesia is given as an
    intravenous injection, after which we will administer a small and safe dose of
    electricity using a well controlled electrical circuitry. This stimulates the brain
    cells and produces a brief seizure which will last less than a minute. You will
    recover consciousness within 30 minutes. Till such time, you will be under the
    supervision of a medical team. The treatment is given on alternate days or
    possibly twice a week, as decided by the treating doctor till sufficient
    improvement occurs – usually fewer than 12 sessions.
    The treatment causes some temporary side effects such as headache and or a
    little confusion, for sometime on the day of ECT. You may notice some lapses in
    memory for events occurring on the days of ECT. Rest of the memory including
    all you have learnt earlier will not be affected. ECT with anesthesia has a few
    serious side effects which are very rare. (If the patient is under 16 years no harm
    to his / her growth or development is known to occur as a result of ECT). Over
    all, the advantages of ECT are expected to outweigh the risks.
    ECT will be administered to you only if you consent for the treatment. You
    have a right to refuse now as well as withdraw the same during the course of the
    treatment. In either case, the best available alternative treatments will be offered
    without prejudice. You are also free to reconsider the matter and request ECT if
    need be. Please feel free to contact us.
    48 ECT ADMINISTRATION MANUAL

    DECLARATION OF CONSENT FOR ECT


    I have been advised that my present condition requires Electro Convulsive
    Therapy (ECT), and sufficiently informed about the procedure with its risks and
    benefits. I am aware that I have the right to refuse this treatment now or at any
    time during the course of treatment without compromising my right to obtain all
    other services,
    I _____________________________________________________________
    (Name of the patient)
    hereby solemnly declare my consent for the administration of ECT as
    required to myself.
    I own full responsibility for the consent and exonerate NIMHANS from any
    consequences.
    _______________________________________________________________
    (Signature of Relative) (Doctor’s signature)
    _______________________________________________________________
    (Name of the Doctor) (Doctor’s signature)
    In the event the patient cannot comprehend the information and consent
    I, ____________________________________ having understood the
    nature of the disease and treatment (ECT) offered to
    _________________________________________________________________________
    who is my __________________________________ give my consent for the
    treatment.
    I own fully responsibility for consent and exonerate NIMHANS from any
    consequences.
    Date:
    ___________________
    (Signature of Relative)

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