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monitored her for a few hours
before transferring her to the
hospital with the pediatric unit.
Dantrolene was drawn up and at
the ready (a pediatric intensivist
IN THE EVENT Use expired dantrolene to train your staff
on how to mix and administer the drug in an MH emergency.
who was consulted indicated that,
at his institution, dantrolene was always given after masseter muscle
rigidity), but it was so far not needed in this case. The first creatine
kinase test returned a level of 5,000 and attending staff watched for
myoglobin-darkened urine while periodically repeating the CK tests.
While the patient's CK level reached 12,000 at its peak, she recovered
completely. The anesthesiologist stated that he didn't appreciate the
seriousness of the muscle rigidity before this.
The response team and patient were extremely fortunate. Looking
PLAN IN PLACE
• A method of continuously monitoring
end-tidal CO2 levels, blood oxygen satureating MH depends on advance
ration and core body temperature.
preparation for an unanticipated
• A way to actively cool patients, such as
event. The delivery of potentially
hypothermia blankets, a refrigerator with
triggering anesthetics must be backed by a isotonic saline for infusion and irrigation, or
response plan, because prompt recognition large plastic bags to fill with ice.
and action are essential to optimal out• An MH cart or kit containing vials of
comes. All locations in which general anes- dantrolene (many states and accreditors
thesia is administered should have immedi- require 36), preservative-free sterile water,
ate access to:
60mL syringes, transfer devices, and other
• A plan, such as MHAUS's emergency
reversal agents and surgical supplies (listtherapy poster or procedure manual.
ed at www.mhaus.org).
• The MH hotline number: (800) 644-9737
The Elements of MH Preparation
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