8. Your anesthesiologists never use potent inhaled anesthetic
agents, but have succinylcholine on hand to assist intubation dur-
ing airway emergencies. Do you still need to have a fully stocked
MH cart available?
a. No, because the risk of MH is so low
b. No, because succinylcholine is used only for emergency airway
management
c. Yes, because you need to manage treatable emergencies
Answer: c
The reason: Patients can develop MH in response to succinylcholine
alone. A practical alternative to stocking succinylcholine for emer-
gency airway management might make this question moot.
Rocuronium, a non-depolarizing muscle relaxant given intravenously
in relatively large doses, induces paralysis as rapidly as the MH-trig-
gering agent succinylcholine. The advantages of using succinylcholine
— rapid onset and short duration — as an emergency agent to facili-
tate airway management can therefore be achieved with a less risky
alternative.
9. Do you need a MH cart if your providers use only propofol and do
not stock succinylcholine?
a. No, there is no risk of MH crisis if triggering agents are not used
b. Yes, MH can occur in some patients who are not exposed to trig-
gering agents
Answer: a
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