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S U R G I C A L
E M E R G E N C I E S
back, it may have been advisable to transfer the patient as soon as possible, and perhaps the anesthesiologist should have sent her to the hospital with the pediatric ICU, as it offered the highest level of critical
care for critical patients, after alerting them to prepare their MH cart.
Standard doses of succinylcholine are less than 1mg/kg, so 2 doses
of 20mg for a 65-pound girl may have been excessive and the reason
for jaw rigidity. The anesthesiologist might have administered propofol to keep the patient from waking while attempting to lower the
CO2. During the post-treatment observation stage, you also need to
see the urine sooner rather than later. If you're concerned about the
lack of urine output, add extra fluid and give a small dose of diuretic.
In terms of followup testing, the family
should be referred to
an MH expert to
assess the advisability
of a muscle biopsy
contracture test or
genetic testing. Her
parents should be
made aware of the
potential danger of
anesthetization and
advised to outfit her
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