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thetic (either succinylcholine or an inhalation agent). 2. Recognize and react. Focus training on learning to recognize MH symptoms and on treating it as quickly as possible. It's well-document- ed that if dantrolene is given within the first 10 minutes after symp- toms develop, out- comes are much bet- ter. 3. Get everyone involved. The best simulations are when the leader continually assigns roles to the partici- pants. The people being assigned are par- ticipating, and the oth- ers know they might be assigned a role at any point, so they're also fully engaged and focused. 4. Put roles in writing. Write roles out on cards and have the team leader hand them out as people come into the room. People should be able 9 4 • 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 Important Safety Information The use of The use of Revonto in the management of malignant hyperthermia crisis is not a substitute for previously known supportive measures. These measures must be individualized, but it will usually be necessary to discontinue the suspect triggering agents, attend to increased oxygen requirements, manage the metabolic acidosis, institute cooling when necessary, monitor urinary output, and monitor for electrolyte imbalance. Patients who receive i.v. dantrolene sodium preoperatively should have vital signs monitored. If patients judged malignant hype If patients judged malignant hyperthermia susceptible are administered dantrolene sodium preoperatively, anesthetic preparation must still follow a standard malignant hyperthermia susceptible regimen, including the avoidance of known triggering agents. Monitoring for early clinical and metabolic signs of malignant hyperthermia is indicated because attenuation of malignant hyperthermia, rather than prevention, is possible. Despite initial satisfacto Despite initial satisfactory response to i.v. dantrolene there have been reports of fatality, which involve patients who could not be weaned from dantrolene after initial treatment. The administration of i.v. dantrolene is associated with loss of grip strength and weakness in the legs, as well as drowsiness and dizziness. There have been reports of thrombophlebitis following administration of intravenous dantrolene. Tissue necrosis secondary to extravasation has been reported. Injection site reactions (pain, erythema, swelling), commonly due to extravasation, have been reported. Fatal and non-fatal liver disorders of an idiosyncratic or hypersensitivity type may occur with dantrolene sodium therap hypersensitivity type may occur with dantrolene sodium therapy. To see the full prescribing information visit www.revonto.com. © 2016 US WorldMeds, LLC. Revonto is a registered trademark of US WorldMeds, LLC. REV-P80-1215 *from the date of manufacture † or until solution is clear ® 36 month shelf life* Ready to administer in 20 seconds † Are You Prepared for a CRISIS? Visit www.revonto.com or call (877) 411-USWM (8796) to learn more about Revonto and to see the full Prescribing Information.