There should ideally be a designated area for ECT within each general psychiatry unit; this is recommended on the basis of patient convenience and economy of nurse staffing. However, it is recognised that with the numbers of patients undergoing ECT falling, there is an increasing trend for psychiatric services to share one facility in an attempt to maintain standards of anaesthetic and psychiatric practice within the confines of a National Health Service budget.

Suite layout

The design of the ECT suite will depend on the type of service provided. The minimum requirement for a local unit with small patient numbers is two rooms: a treatment room and a recovery room. An ECT unit where patients would be required to wait before treatment will need a waiting room in addition. A suite providing ECT to neighbouring psychiatric units should ideally include an ECT office and a final post-ECT waiting area.

The waiting room should be a comfortable, relaxing and informal environment, with a range of distractions, for example an outside window, pictures and magazines, and toilet facilities should be available. Patients’ arrival should be booked to provide a smooth throughput with the minimum amount of waiting time. Patients waiting for ECT should not be able to see into the treatment area while the treatment is taking place, and patients waiting for treatment should not be in the same room as patients who have completed their treatment.

The treatment room should be accessible from the waiting area. In the treatment area the patient is assisted onto a trolley or bed and prepared for treatment. This room should be well lit and contain all the equipment necessary for routine and emergency treatment. It should be big enough to allow unrestricted staff movements. Adequate work surfaces and a sink with hot and cold water should be available. There should be a clock with a second hand. If nitrous oxide and/or anaesthetic inhalation agents are ever used, the treatment room should be equipped with scavenging equipment and agent monitoring. There should be good sound-proofing between the waiting area and treatment room.

The recovery area must be large enough to accommodate easily the trolleys and associated monitors of all the patients who are regaining consciousness, and there should be enough room for recovery nursing staff to work in.