tion causes end-tidal CO
2
to rise. We get a lot of calls saying, 'We can't
get the carbon dioxide down.' It turns out it's a problem that's ventila-
tory in nature, the endotracheal tube is clogged or too small.
• What about post-op fevers? We get calls involving patients with fevers
in post-op recovery. That's almost never a sign of MH. Some patients
do suddenly develop high temperatures after surgery, over 103º. There
are many theories, and it's certainly alarming. There's good reason to
think of MH, but almost none of the cases we've seen develop after
surgery. Recovery room MH is almost unheard of.
• The perils of diagnosis. An incorrect MH diagnosis can put a patient at
significant harm in the immediate present as well as over the course of
a lifetime. Giving
dantrolene is not
innocuous. In a small
vein, it can cause a
blood clot. It can cause
muscle weakness that
could lead to breathing
difficulties after sur-
gery. Similarly, the risk
of labeling patients as
MH-susceptible when
they're not is you can't
tell if they're a case for
sure. They'll need to be
observed in the hospi-
tal, they're labeled for
the rest of their life,
1 0 2
O U T PAT 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 | January 2015
