O C T O B E R 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 4 5
Anesthesia provider
• Diagnoses MH and calls the "code"
• Stops all volatile anesthetics
• Stops warming the patient
• Hyperventilates the patient to 10
L/min or more
• Intubates patient, if not intubated
• Calls the MH hotline (800-644-9737)
• Assesses the patient for rigidity
• Places an arterial line
• Administers propofol and/or narcotic
relaxant
• Inserts esophageal temp probe or
axillary temperature probe
• Inserts nasogastric tube for lavage as
needed
• Administers dantrolene
• Administers calcium, then glucose
and
insulin if ECG shows peaked T waves
• Injects bicarbonate if T waves are
not peaked and arrhythmia is present
• Orders arterial blood gas, chemistry,
creatine kinase and coagulation stud-
ies
Surgeon and scrub tech
• Completes the procedure, if possible
• Lavages wound with cold saline
• Assists with arterial line and IV
placements
• Reports muscle rigidity and color of
blood
• Places ice packs around the patient
Nurse circulator
• Brings in the MH cart
• Mixes dantrolene with
non-bacteriostatic sterile water
• Calculates the needed
Less is often more when it comes to assigning
responsibilities during high-pressure situations,
so create staff assignment cards – general ones
are available from MHAUS — to fit the size and
makeup of your staff. Keep in mind that every
member of the clinical team, from anesthesia
providers to nurses, approaches emergencies
with their own sets of expectations. Assigning
them roles with the entire team in mind ensures
everyone is working together to save the patient.
Here are the assignments our team members
receive. Use them as a guide to help you decide
what works best for your staff.
— Debra Beauchesne, RN, BSN, CNOR
Assignment Cards Ensure Organized Response
• READY FOR ANYTHING Make sure every member of
your staff knows how to reconstitute dantrolene,
because you never know who will be pressed into duty
during a real-life emergency.
Debra
Beauchesne,
RN,
BSN,
CNOR
