| Summary: | Electroconvulsive therapy (ECT) is a treatment that uses a small electrical current to produce a generalized cerebral seizure under anesthesia in patients with severe depression, as well as other conditions including bipolar disorder, schizophrenia, schizoaffective disorder, delirium, and neuroleptic malignant syndrome. The mechanism of ECT is unknown however changes to the central nervous system resulting from this therapy have been documented and the procedure is considered to be safe and efficacious. A recent Canadian survey of 172 centers identified as conducting ECT indicates that among registered healthcare institutions that conduct this procedure, there exists some variability with regard to written policies and procedures for ECT, the administration of medications, and treatment, however there is generally some consistency with regard to obtaining informed consent and the post-discharge accompaniment of patients. This reported variability has led to a call for the accreditation of facilities that perform ECT in Canada. It is unknown if this variability in performing ECT has had an impact on patient outcomes. ECT may be performed on an inpatient or an outpatient setting in a dedicated ECT treatment suite, hospital post-anesthesia care unit, or an ambulatory surgery site. An estimated 75,000 ECT treatments are delivered annually in Canada, and 90% of these treatments are delivered on an outpatient basis. While an outpatient setting may include non-hospital facilities (e.g. doctor's office, clinic), little is known regarding the safety of conducting ECT specifically in non-hospital environments, and if there are any risks associated with performing ECT in such settings. The present review was conducted to inform decisions regarding the safety and guidelines for ECT therapy delivered outside of hospital settings
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