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7 8 O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A P R I L 2 0 1 4 have gotten from watching a video. For example, our chilled fluids are locked up in a Pyxis system, so we couldn't ask a scrub tech to go get them. We had to have a nurse be responsible for that job. Also, a lot of people didn't know where our ice machine was. Those are key con- cerns that you should address ahead of time, not during a real emer- gency. Although there were some rough spots, fortunately our major processes were in order. A big reason for that was another improve- ment I implemented. S U R G I C A L E M E R G E N C I E S Safety Information Management of Malignant Hyperthermia (MH) crises requires various supportive measures individualized for the patient's condition. Administration of Dantrium ® IV is one component of therapy and should not be considered a substitute for these measures. Even when properly treated, an MH crisis can result in death. Adverse events with Dantrium ® IV include loss of grip strength, weakness in the legs, drowsiness, and dizziness, thrombophlebitis, and tissue necrosis/injection site reactions secondary to extravasation. There have been rare reports of pulmonary edema, urticaria and erythema. Symptomatic hepatitis (fatal and non-fatal) has been reported at various dose levels of the drug. Fatal and non-fatal liver disorders of an idiosyncratic or hypersensitivity type may occur with Dantrium ® therapy. In case of overdose, symptoms include, but are not limited to, muscular weakness, lethargy, coma, vomiting, diarrhea, and crystalluria. For acute overdosage, general supportive measures should be employed. Please visit www.dantrium.com for additional product information. For full prescribing information, please see reverse. *JHP's Dantrium ® IV has a 36 month shelf life at manufacturing point. There is always some lag period between manufacturing date and when the product ships to the end user, which varies based on when the order is placed. DAN3000-313 www.dantrium.com • MH is triggered in suscep- tible individuals primarily by the volatile inhalational anes- thetic agents isoflurane and desflurane and by the mus- cle relaxant succinylcholine. • A telltale sign of MH is masseter muscle rigidity —a severe, sustained contraction of the jaw muscle you might see after you administer succinylcholine. • Stock an MH cart containing dantrolene and the necessary supplies to help reverse the process. Have 36 dantrolene vials (containing 20mg/vial) available wherever you administer general anesthesia. • With aggressive treatment, the mortality rate of MH is less than 5%. Without prompt and appropriate treatment, patients can die as a result of cardiac arrest, hypoxia or internal hemorrhaging. IN BRIEF 4 Fast Facts About MH WELL-STOCKED Your MH cart should contain 36 vials of dantrolene sodium. OSE_1404_part2_Layout 1 4/4/14 2:39 PM Page 78