Practical Problems in the Use of the MECTA EEG Monitored ECT

Abstract

The MECTA is an American made ECT machine which provides single channel EEG monitoring. This gives great improvement in the control of ECT. The Nepean Hospital Psychiatry Unit was opened in February 1991 and was equipped with a MECTA machine as well as the standard Kabronics machine. We found a range of practical difficulties and complications in commencing its use and with its continued use. There are limitations with the machine itself including the standard starter kit not being satisfactory regular use was not started until hand held paddles were obtained. The procedure is significantly more complex and time consuming, it requires more staffing input, it needs a more detailed knowledge base, and there are limitations on the EEG. There are some interesting empirical observations we can make about our results; any medication with anticonvulsant effect including the short acting benzodiazepines reduces the effectiveness of the ECT; and generally the EEG indicates a seizure continuing for half as long again as the observed modified fit. Overall, we are very pleased to be able to use EEG monitoring and in conjunction with our good quality oximeter provides a welcome high standard of safety and accuracy in the provision of ECT. This brief presentation will focus on the practical difficulties in the use of this machine and may be of assistance to others interested in EEG monitored ECT.