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with a medical ID bracelet until then.
Proceed with caution
You can safely perform surgery on MH-susceptible patients as long as
CHAIN REACTION
the anesthesia provider avoids the use of
What Happens
When MH Occurs
agents known to trigger MH reactions and con-
M
H-susceptible
patients possess
a genetic mutation that
creates abnormal proteins in their muscle
cells. When these proteins are exposed to
triggering agents or
conditions, the muscle
cells release an abnormal amount of calcium,
which causes sustained muscular contraction, which ramps
up metabolism rate and
heat. The cells, depleted of energy source
adenosine triphosphate, die and dump
potassium into the
bloodstream. This
causes hyperkalemia,
cardiac arrhythmia,
and the release of kidney-toxic myoglobin.
tinuously monitors the patient's exhaled CO2
concentration, minute ventilation and temperature (during surgery and in recovery). MHAUS
doesn't recommend skin temperature to detect
or confirm MH. Review the syndrome's signs
and treatment and, while the patient shouldn't
be pre-treated with dantrolene, keep a stocked
MH kit or cart close by in the OR. The decision
to anesthetize an MH-susceptible patient in an
outpatient facility is yours to make.
A patient, 25, with a history of malignant
hyperthermia based on 1 clinical episode had
an uneventful knee arthroscopy under general anesthesia because non-trigger agents were
used. While it's long been advised that MHsusceptible patients be kept in recovery for at
least 4 hours due to concerns over the potential risk of episodes, even when non-trigger
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