J U L Y 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 3 1
10L/min to flush volatile anesthetics and
lower ETCO
2
. If available, insert activat-
ed charcoal filters into the inspiratory
and expiratory limbs of the anesthesia
machine's breathing circuit. Replacing
the machine's soda ash filter with a
charcoal filter can quickly filter out
residual anesthesia gases that are caus-
ing an MH episode.
4. Give IV dantrolene rapidly through a
large-bore IV, if possible. Repeat as fre-
quently as needed until the patient
responds with a decrease in ETCO
2
,
decreased muscle rigidity and/or lowered
heart rate. Large doses (>10mg/kg) may
be required for patients with persistent
contractures or rigidity. Follow with addi-
tional supportive care, such as cooling the
patient with ice and cold saline IVs, check-
ing blood glucose levels and other appro-
priate monitoring.
— Cheryl M. Gallaga, MSNEd, RN, CNOR
For more information about MH
response protocols, see MHAUS's
"Managing a Crisis" at
osmag.net/tb3FMD.
