J U LY 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 2 5
stocked MH cart equipped with all necessary
drugs and equipment to prevent and treat a
crisis (see question 2 for more details).
Perform a mock MH simulation drill annu-
ally. As someone who's on the other side of
the hotline, I can tell you that facilities that
hold annual drills are noticeably calmer and more goal-directed during a real
crisis.
You can purchase MH simulation systems or simply create your own mock
drill. Set aside part of a day and have your staff walk through responding to a
patient experiencing symptoms of MH. Practice calling the MHAUS hotline and
reconstituting expired dantrolene to get the full experience of an actual emer-
gency response.
During the mock drill, assign staff specific roles. If you work in a freestanding
surgery center, establish a prearranged transfer plan to the closest hospital.
Simply knowing which ER is nearby isn't enough. Communicate your plans with
the nearest hospital and ensure that they have the supplies and capabilities to
handle a transferred MH patient.
2. What supplies should always be on hand?
The most important component is dantrolene. To treat an MH episode, an initial
dose of dantrolene at 2.5 mg/kg is recommended. Since some MH patients may
require as much as 10 mg/kg dantrolene at the start of an episode, we recom-
mend having at least 700 mg available. Note, though, that this is based on an
average patient weight of 70 kg, which is lighter than many patients nowadays.
For Dantrium/Revonto, this translates to a minimum of 36 vials on hand. For
Ryanodex, it's a 3-vial minimum. Additionally, dantrolene always requires sterile
water for reconstitution.
You also want to make sure your MH cart contains sodium bicarbonate, dex-
Pamela
Bevelhymer,
RN,
BSN
z BE PREPARED Ensure you have enough dantro-
lene, as well as cold saline, sterile water and other
supplies, on hand to treat an MH episode.