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An effective MH response must reach beyond the OR. The simula- tions taught us that neither the pharmacy nor the ICU had a firm understanding of MH or their role in the event of a crisis, so we had to conduct additional education — including post-crisis education for pharmacists and ICU nurses — to make sure everyone was prepared. For the second year, we decided to take the simulation one step further, with a hand- off to the ICU. In a cri- sis situation, ICU nurs- es would have to treat an intubated patient and have their post- acute protocols in place: oxygen, ice to bring down the patient's body temper- ature (but not so much that the patient is at risk of becoming hypothermic) and more dantrolene. Our first-year simula- tion ended in the OR once we established that the patient's vitals 7 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 7 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-P80A-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.