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Case Report Highlights Vigilance for Electroconvulsive Therapy Preprocedural Fasting
Osama Bhatti1, David Athan, Louise Dawson
1Monash Health, Victoria, Australia.
Abstract:
This case report describes an instance of aspiration in a 50-year-old male who surreptitiously broke his fast before his second Electroconvulsive therapy despite multiple fasting confirmations and strict food security measures, leading to subsequent necessitating intensive care unit management. Although not confirmed, there was high suspicion of intentional sabotage. This case highlights the importance of ensuring fasting compliance in psychiatric patients and encourages clinicians to practice vigilance in patients who may be considered high risk and falsify fasting adherence.
Insights
A psychiatric patient intentionally broke fasting before Electroconvulsive therapy, leading to aspiration and intensive care. This case underscores the need for vigilance regarding fasting compliance in high-risk individuals.
Area of Science:
- Medical Case Reports
- Patient Safety
- Anesthesiology
Background:
- Electroconvulsive therapy (ECT) requires fasting to prevent aspiration.
- Ensuring patient fasting compliance can be challenging, especially in psychiatric settings.
- Aspiration is a serious complication that can necessitate intensive care.
Purpose of the Study:
- To report a case of aspiration due to intentional fasting violation before ECT.
- To emphasize the importance of vigilance in confirming fasting adherence in at-risk psychiatric patients.
- To highlight potential intentional sabotage of fasting protocols.
Main Methods:
- A case report of a 50-year-old male patient undergoing ECT.
- Description of the patient's surreptitious fasting violation.
- Documentation of the subsequent intensive care unit admission.
Main Results:
- The patient aspirated after breaking his fast before ECT.
- Intensive care unit management was required.
- High suspicion of intentional sabotage of fasting protocol was noted.
Conclusions:
- Vigilance in confirming fasting compliance is crucial for psychiatric patients undergoing procedures like ECT.
- Clinicians should be aware of the potential for patients to falsify fasting adherence.
- Proactive measures and heightened awareness are necessary to prevent aspiration events in this population.
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