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A N U A R Y 2 0 2 1 • O U T P A T I E N T S U R G E R Y . N E T • 3 3
Creating an MH escape room is an alterna-
tive teaching style that will capture the
attention of your staff. There are any num-
ber of questions about MH you can use to
create an escape room scenario, but here
are five to get you started based on infor-
mation found on the website of the
Malignant Hyperthermia Association of
the United States (mhaus.org).
— Danielle Bouchat-Friedman
1. What are the last four digits of the
MHAUS hotline?
a. 3797 c. 9797
b. 9737 d. 3737
Answer: b
The complete hotline number is 800-644-
9737. MHAUS experts are board certified anes-
thesiologists with special expertise in MH and
proper ways to manage a crisis. They man the
line 24 hours a day to provide surgical teams
with real-time advice on how to stabilize stricken
patients. Post the hotline number on your MH
cart and make sure it's easily visible for quick
reference during an emergency. Be sure phones
in ORs have access to an outside line, so a staff
member can reach an MHAUS expert and direct
the surgical team through response efforts.
2. What are the early signs and symptoms
of malignant hyperthermia?
a. decreasing ETCO₂; bradycardia; muscle
rigidity; tachypnea; hypoxia
b. rising ETCO₂; bradycardia; muscle rigidity;
tachypnea; hypoxemia
c. rising ETCO₂; tachycardia; muscle rigidity;
tachypnea; hypoxemia
Answer: c
An increase in a patient's ETCO₂, a decrease in
arterial oxygen and tachycardia are often the
first signs of MH. Other symptoms to be aware
of are muscle rigidity, hyperkalemia and tem-
perature elevation. A rise in temperature is often
the last sign of MH, when treatment of MH has
already started. As soon as early symptoms are
noticed, stop administration of volatile anesthet-
ics. Insert activated charcoal filters into the
inspiratory and expiratory limbs of the breathing
circuit and hyperventilate the patient with 100%
oxygen at flows of 10L/min to flush volatile anes-
thetics. Bring the MH cart to the OR and start
reconstituting dantrolene to prepare syringes
that will be administered through the patient's
peripheral IV line.
3. What is the initial loading dose
of dantrolene needed to stabilize patients?
a. 2.5 mg/kg b. 5 mg/kg c. 10 mg/kg
Answer: a
Dantrolene, which directly interferes with mus-
cle contraction to decrease calcium build-up in
muscle cells, is the only specific treatment for
MH. Administer 2.5 mg/kg of dantrolene rapidly
MIND GAMES
Would You Get Out of an MH Escape Room?
KNOWLEDGE IS KEY Combination locks with letters, numbers and symbols are ideal for the
MH escape room experience.
