Janet source rebuild

ECT and Ketamine Nursing Workflows

A procedure-oriented presenter deck rebuilt from Janet's ECT slides and IM ketamine protocol notes, with clear separation from intranasal esketamine.

Sources: ECT.pptx, IM ketamine protocol, ketamine background

ECT source frame

ECT is a structured treatment under anesthesia

ReferralIndication, prior response, urgency, alternatives. ConsentBenefits, risks, alternatives, SDM where applicable, withdrawal right. ProcedureElectrical stimulus induces controlled therapeutic seizure. RecoveryAirway, vitals, cognition, falls, discharge safety.

Source visual

ECT deck visual anchors

Extracted ECT source-deck visual Extracted ECT source-deck visual Extracted ECT source-deck visual

Extracted ECT images are draft reconstruction references pending rights/provenance review.

Pre-ECT

The unit nurse prepares the patient and the handoff

Identity and consentConfirm current consent and right-to-withdraw process. NPO and medsFollow ordered holds and morning medication instructions. BaselineVitals, cognition, falls risk, diabetes checks where applicable. BelongingsRemove jewelry, contacts, dentures, hearing aids per policy. Anxiety teachingExplain transfer, anesthesia, recovery, and reorientation. HandoffCommunicate comorbidities, changes, meds, allergies, and risk.

Post-ECT

Recovery is nursing surveillance plus reorientation

Airway/vitalsWatch respiratory status and anesthesia recovery. CognitionAssess confusion, memory, orientation, and agitation. FallsReassess risk before leaving unattended. OutpatientResponsible adult, discharge instructions, and no driving per policy.

Route separation

Ketamine workflows are not interchangeable

WorkflowIntranasal esketamineIM ketamineECT RouteNasal spray product protocolLocal IM protocolProcedure under anesthesia MonitoringBP, sedation, dissociationVitals, Aldrete/recovery, environmentAirway, seizure, cognition, falls PolicyMonograph and clinic procedurePsychiatrist order/local protocolECT service/anesthesia policy

Web adaptation

Build a three-lane workflow map

  • ECT pre/intra/post role cards.
  • Esketamine monitoring lane.
  • IM ketamine protocol lane.
  • Escalation triggers and discharge restrictions.
The web version should make route confusion difficult by requiring learners to sort each action into the correct workflow lane.