J U L Y 2 0 2 0 • O U T P A T I E N T S U R G E R Y . N E T • 3 3
In the rare event your OR staff finds itself facing a true malignant
hyperthermia (MH) emergency, instant access to life-saving drugs
and solutions is of paramount importance.
According to the Malignant Hyperthermia Association of the
United States (MHAUS), the following drugs, solutions and agents
should be on all MH carts:
• Dantrolene – To treat an MH episode, an initial dose of
dantrolene at 2.5 mg/kg is recommended.
• Sterile water for injection USP (without a bacteriostatic agent)
– It is mandatory to get dantrolene sodium to its effective site, the
skeletal muscle.
• Sodium bicarbonate (8.4%) – 50 ml x 4
• Dextrose (50%) – 50 ml vials x 2
• Calcium chloride (10%) – 10 ml vial x 2
• Regular insulin – 100 units/ml x 1 (refrigerated)
• Lidocaine for injection (2%) – 100 mg/5 ml or 100 mg/10 ml in
preloaded syringes (3). Amiodarone is also acceptable. ACLS
protocols, as prescribed by the AHA, would be followed when
treating all cardiac derangements caused by MH.
• Refrigerated cold saline solution – A minimum of 3,000 ml for
IV cooling.
To view the full list of items (supplies, equipment, etc.) that
should be included on your MH cart, visit: osmag.net/NqPXo3
– Outpatient Surgery Editors
Essential Drugs of the MH Cart
Do you stock all of these key items?
see that the simulated dantrolene was orange because they must
reconstitute the real medication to an orange-colored uniform suspen-
