The ECT clinical lead should streamline the preassessment and consent processes for all ECT patients by setting up a collaborative system with ECT clinics and experienced anaesthetists. The mental capacity issues that affect informed consent should be acknowledged.
Standards specific to ECT clinics should be available, including a minimum of four rooms: a waiting room, treatment room, recovery area and post-ECT waiting area.69 The clinic should have a reliable source of oxygen supplied either by pipeline or cylinder with a reserve supply immediately available.
Recommendations for standards of monitoring during anaesthesia and recovery are stipulated by the Association of Anaesthetists and should be adhered to for all patients undergoing ECT.22
General anaesthesia for dentistry should be administered only by anaesthetists in a hospital setting as defined by the Department of Health report reviewing general anaesthesia and conscious sedation in primary dental care.77
Patients undergoing sedation or general anaesthesia by an anaesthetist should have appropriate preoperative assessment with appropriate risk stratification.
Anaesthesia may be required for radiotherapy, to facilitate patient positioning and to alleviate pain. Owing to the unique nature of the procedures involved in radiotherapy, the remoteness of the location and the lack of direct access to the patient, only appropriately experienced anaesthetists familiar with the therapy should embark on anaesthesia for these patients.73
Anaesthetists should be familiar with the specific needs of patients with cancer, including the following:
Patients with tumours of the lower body may be amenable to regional anaesthesia. Equipment and facilities to instigate, monitor and manage regional blockade should be available.74
External pacing equipment should be immediately available before beginning DC cardioversion.2
