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 7
CO
2
, abnormal heart rhythm, rapid breathing
and brown or cola-colored urine — a high
temperature is one of the more alarming ones
for many healthcare professionals.
It may be (somewhat) comforting to know
that it's not uncommon for patients to develop
a high temperature after surgery. If your
patient suddenly spikes a 104-degree fever in
recovery, something other than MH is proba-
bly at play.
Post-op MH is extremely rare, and when it
does occur, it happens only within a few min-
utes of turning off the anesthetic. If a patient
develops a high temperature in recovery, first
check for any of the other MH symptoms.
Without muscle rigidity, heart arrhythmia or another associated symptom, MH
almost certainly isn't occurring.
5. A pediatric patient was given sevoflurane and is
now experiencing muscle rigidity. What do we do?
It can be very hard to distinguish MH and sevoflurane-induced myoclonus and
muscle rigidity. Add to it that sevoflurane is often given to pediatric patients,
and this quickly becomes a provider's worst nightmare.
One of the things we immediately tell facilities is to check the patient's end-
tidal CO
2
. Studies have shown that a high reading almost always accompanies
MH. If the muscle rigidity is accompanied by high end-tidal CO
2
that is not
responding to increasing ventilation, immediately begin the steps to treat MH.
But if there are no other symptoms besides muscle rigidity, it is likely not MH.
Remember to call the hotline if there are any doubts about whether you're fac-
The Malignant Hyperthermia Association of the
United States (mhaus.org) has a new program
called the MH Prep Check. For $2,000, you can
have an MH hotline consultant come to your facility
to thoroughly check that you're prepared for an MH
emergency. The consultant will give a 60- to
90-minute training session that includes:
• a readiness walk-through of the facility;
• an on-site MH mock drill; and
• a discussion of a facility-specific plan to transfer or
receive an MH-susceptible patient to the ER.
ON-SITE TRAINING
Bring an MH Expert
to Your Facility
