MH episodes. Ryanodex comes in 250-mg
vials, one of which can be reconstituted in 5
ml to 10 ml sterile water and rapidly infused
for an initial loading dose in patients who
weigh up to 100 kg. But with increasing num-
bers of obese patients presenting for surgery,
more might be required, so having (a) 5 vials
on hand would be best if you stock
Ryanodex.
Dantrium and Revonto, the other formula-
tions of dantrolene, come in 20-mg vials, each
of which requires 50 ml to 60 ml of sterile
water to reconstitute. Up to 250 mg, or 12 to
13 vials, may be required for the initial loading
dose of these formulations. It's therefore rec-
ommended that you stock (b) 15 50-ml to 60-
ml vials of sterile water to prepare these
drugs for administration.
The only answer that doesn't work here is
"c," because stocking IV bags of sterile water
creates the possibility that staff, during the
rush of an emergency response, might instead
hang bags of saline solution and administer it
to the patient. MHAUS has received reports of
providers making that exact mistake during a
crisis.
4. MH-susceptible patients should not be
operated on in the outpatient setting.
a. true b. false
3 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 1 8
