they can't get volatile gas or succinylcholine. Since it's an inherited dis-
ease, all the people in their entire family are going to be implicated. It's
a very serious decision. At the same time, however, you don't want any-
one to miss it, to not treat it. And you never want to wait too long to
react. This difficult diagnosis is the reason why the MHAUS hotline
exists.
• A risk in response. You've got to be extremely aggressive in keeping
the patient's temperature under control. But people overtreat hyper-
thermia. They continue the cooling methods with ice baths or cooling
blankets even once the temperature has reached 38ºC. By that point,
you have to stop. Hypothermia is a real concern. If the patient gets
too cold, they'll suffer other abnormalities. They'll stop metabolizing
drugs, it'll delay their return to wakefulness, there's a higher risk of
infection, they could suffer blood clots. Especially since they've been
treated with dantrolene.
• Training the treatment. If you do simulations on at least a yearly basis,
the process stays fresh in your mind, you can work out the kinks.
Many providers will go their entire careers and never see an incident.
But it's really important, getting everybody used to the treatment. OSM
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January 2015 | O U T PAT I E N TS U R G E R Y. N E T
E-mail dbernard@outpatientsurgery.net.
