Bagcilar Medical Bulletin (Dec 2022)
Evaluation of Anesthesia Administrations in Electroconvulsive Therapy in the COVID-19 Pandemic Process
Abstract
Objective:The aim of this study is to evaluate the approach of anesthesiology physicians to electroconvulsive therapy (ECT) in the Coronavirus disease-2019 (COVID-19) pandemic process, the protective safety measures taken before and during ECT, and their approach to the use of personal protective equipment (PPE).Method:A questionnaire form including questions about changes in ECT treatments, use of PPE, employee and patient safety during the pandemic process was prepared. Anesthesiology lecturers, specialist doctors and research assistants throughout Turkey were invited to participate in the research by sending the link of the questionnaire form via either the online social network application WhatsApp, or emails through the Turkish Society of Anesthesiology and Reanimation.Results:The forms of 130 participants who responded were analyzed. Of the participants, 43.8% (n=25) were specialist physician, 36.9% (n=57) were research assistant, and 19.2% (n=48) were lecturers. The distribution of the institutions where the participants worked was university hospitals at the rate of 43.8% (n=57), training and research hospitals at the rate of 47.7% (n=67), and private and public hospitals at the rate of 8.5% (n=11). Among the participants, 63.8% (n=83) stated that they continued to perform ECT, while 76.9% (n=100) stated that the number of ECT performed in their hospital decreased. The number of people in the room during ECT was four or less in 73.8% (n=96) of the participants, the rate of the participants who practiced more than 30 min waiting interval between ECTs was 9.2% (n=12). It was found that the rate of high-efficiency particulate air filter application to the anesthesia device was 93.8%, the rate of preoxygenation application was 85.4%, and the rate of applying bag mask ventilation was 77.7%. Forty-five percent of the participants indicated that they always used PPE, 10% stated not to use PPE in any treatment. It was determined that the most commonly used PPEs were N95 (FFP2 or higher) (93.1%), single-layer glove (50.8%), box apron (50.8%), and surgical mask (49%), respectively. The rate of participants who stated that they experienced no difficulty in procuring PPE was 53.8%, whereas 29.2% indicated that they had difficulty in procuring N95 (FFP2 or higher). Of the participants, 66.9% reported that a COVID-19 polymerase chain reaction (PCR) test was performed within 24-48 hours before ECT, 8.5% stated that patients did not undergo COVID-19 PCR testing. It was detected that 14.6% of the participants performed ECT to COVID-19 positive patients and 9.2% had COVID-19 infection after the treatment.Conclusion:ECT treatments have decreased to a great extent during the pandemic process. We wanted to draw attention to procedures that would cause aerosolization in ECT, the importance of PPE use and the differences in practice with questions toward the level of knowledge in line with the recommendations of the guidelines on this subject. We are of the opinion that it will be important to know and implement the guidelines in terms of employee and patient safety in the presence of a possible pandemic.
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