tually recovered.
Our efforts to save the patient's life that day began months earlier
when we heard that regulatory surveyors had asked other facilities
to demonstrate their responses to an MH crisis. We decided to initi-
ate regular sessions for our team to review the contents of our MH
cart, and simulate a response to an emergency situation. Addition-
ally, we wanted our staff to know the correct responses to the fol-
lowing 5 questions.
1. What triggers MH?
The Malignant Hyperthermia Association of the United States
(MHAUS) says about 1 out of every 2,000 to 3,000 people are geneti-
cally susceptible to MH, but many carriers are often unaware of the
risk they face in surgery. Although rare — MH is estimated to occur
in 1 out of every 100,000 surgeries, according to MHAUS — you
must be prepared to respond to an episode during every case. MH is
triggered by commonly used inhalational anesthetics and succinyl-
choline, a neuromuscular blocker and paralyzing agent. Cardiac
arrest, brain damage, internal bleeding and failure of body systems
can result. The cause of death is usually secondary cardiovascular
collapse.
2. What are the early warning signs?
Onset of MH is by marked by increases in CO
2
production, heart rate
and metabolism, muscular rigidity and breakdown, disturbances of
body chemicals and a heightened acid content in the bloodstream.
The anesthesiologist is often the first to notice the onset of MH, but
everyone in the OR should be trained and alert to recognize the early
signs and symptoms, and feel empowered to raise their concerns to
everyone in the room.
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