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9 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 1 6 One of the critical elements when you're conducting malignant hyperther- mia simulations is the debriefing that follows each drill. We've found that that's where a lot of the learning takes place. And every time we do it, we learn something new. So we always make it a point to talk to the staff afterward. What did we learn? What went well? What can we improve on? Did everyone clearly understand what their roles were? The feedback is always valuable. For example, we learned over time that when we packed our entire staff into the OR for a simulation, it wasn't as conducive to learning as we wanted it to be. We simply weren't going to get the full benefit of the simulation with 30 people in the room. So now when we do simulations, we split the staff and do half on Wednesdays and the other half on Fridays. At another of our debriefings, people said it wasn't always 100% clear whom the person running the drill was talking to. To improve communication we began making it a point to use first names: Lynn, I need you to go get this. Sarah, I need you to call the MH line. And so on. And the person being called on acknowledges the instruction, as well: Yes, I'll do that. Sometimes the things you take for granted turn out to be challenges. Like ice. We knew from Malignant Hypothermia Association of the United States protocol that we'd need to apply ice to the patient in a real MH emer- gency. We could bring in a bucket of ice, but we had nothing to put the ice in. Somebody was having to run to get bags every time. Now we've added clear plastic bags to our MH cart. We also realized that our ice machine was too slow. Do you know how slowly that ice machine gives ice, people were saying. The solution: In an emergency, we take the top off and fill the bucket instead of using the dispenser. That may sound obvious or intuitive, but it's not the kind of riddle you want to be having to solve when someone's life is on the line. Having regular drills and post-drill discussions can help you address all the issues that might arise, and do so before it's a real emergency. — Lynn Gettrust, MSN, RN, ACNS-BC Ms. Gettrust (lynn.gettrust@va.gov) is a perioperative clinical nurse specialist at the Department of Veterans Affairs in Waukesha, Wis. This article reflects her views alone and does not necessarily reflect the views or policies of the Department of Veteran Affairs or the United States Government. Post-MH Drill Discussions Help Fill Important Gaps • ROOM TO THINK Having a manageable number of people in the OR during an MH drill promotes learning.