Patient Safety, Practices & Tips

Malignant Hyperthermia Is Your Facility Prepared?

[Editor’s note: This poster was accepted for presentation at the 2020 AORN National Conference and Surgical Expo, which unfortunately has been canceled because of the current Covid-19 crisis. However, the information contained on the poster contains important information that all healthcare facilities should be aware of and implement to prevent Malignant Hyperthermia and to minimize patient harm and prevent patient mortality, so we asked the poster authors to discuss their findings here. 

By Thereza  B. Ayad, RN, DNP, CNOR and Lynn Razzano, RN, MSN, ONC CMSRN

Malignant Hyperthermia (MH) complicates 1:100,000 adult surgical cases. MH is a severe reaction to a dose of anesthetics – infrequently, extreme exercise or a heat stroke can trigger MH in someone with a muscle abnormality where the individual’s muscle cells have an abnormal protein on their surfaces.

Although rare, MH can be fatal. 

MH symptoms/ manifestations include:

  • A dramatic rise in body temperature, sometimes as high as 113 degrees Fahrenheit
  • Rigid or painful muscles, especially in the jaw.
  • Flushed skin
  • Sweating
  • An abnormally rapid or irregular heartbeat
  • Rapid breathing or uncomfortable breathing
  • Brown or cola-colored urine
  • Very low blood pressure (shock)
  • Confusion
  • Muscle weakness or swelling after the event

MH Preparedness

Early recognition of an MH crisis and prompt emergency response is therefore critical for patient survival. Preparedness means:

  • Following the MHAUS poster.
  • Having an available stocked MH cart ready is key in life-saving efforts. The cart should include, medications, supplies for cooling the patient, supplies for anesthesia. Periodically check for outdated and missing supplies.
  • Having dantrolene available. Dantrolene is the only clinically available drug to treat MH.  Dantrolene is administered intravenously by continuous rapid intravenous push..       

The Result        

Having supplies and medications readily available will minimize patient harm and prevent patient mortality.   

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