ECT Physician Referral

Initiating a referral

1. Contact Forbes Regional Hospital ’s ECT department coordinator, Monday-Friday, 7:00 am - 3:30 pm.
   • Telephone (412) 858-2707 and/or FAX: (412) 858-2989
   • Coordinator will initiate the eligibility process and interface with Dr. P.V. Nickell
   • Potential in-patient ECT admissions: Physicians may contact coordinator during office hours (7:00 am - 3:30 pm)
2. Information usually needed to complete the referral
   • Patient’s name and phone number
   • Current psychiatrist’s name and contact information
   • Psychiatric evaluation, recent drug trial, and history of previous ECT
   • Planning inpatient or outpatient ECT
   • Basic insurance information
3. What happens next?
   • The patient will be contacted by FRC to schedule an appointment for an ECT evaluation
   • If the decision is made to proceed with ECT, the patient will be referred to his/her PCP for a pre-op history and physical and any necessary diagnostic studies
   • Once all results have been faxed to the ECT department, the patient will be contacted to schedule his/her first appointment
4. How long will this initial process take?
   • In most cases we are able to start patients within two weeks of the department being contacted

Required diagnostic studies

Because our patients receive general anesthesia, other than CXR, these tests must be completed within 30 days from first ECT appointment.

1. Pre-op history and physical including:
   • current medication list
   • allergies
   • A basic history and physical exam form
2. BMP, Ca+, Mg, CBC and urinalysis EKG
   • For patients age 40 or older
   • Any patient with a history of CAD, angina, MI, recent pulmonary symptoms, type I or II Diabetes, poorly controlled HTN, or morbid obesity.
3. CXR
   • Any patient age 60 or older
   • Any patient with a clinical condition that dictates further evaluation, i.e., history of MI, angina, recent pulmonary symptoms
   • Films must have been completed in the last 6 months
4. Brain CT or MRI are required only if patient’s history or physical exam shows this to be clinically necessary
5. Spine films, if any orthopedic problems suspected
6. Neuropsychology testing
   • Required for any patients with evidence of a cognitive disorder
   • Strongly recommended for those over 60 but not an absolute requirement
   • Recommended for all patients with significant cognitive symptoms with their depression