Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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3 0 S U P P L E M E N T T O O U T P A T I E N T call 911 and help place ice packs around the patient. • Additional staff members. Respond to requests for help, assist with obtain- ing supplies, help prep dantrolene and replenish the supply of ice that's cooling the patient. 7. Is it safe to treat at-risk patients in the outpatient setting? Yes, surgery can be performed on patients who are at risk of MH — those who've had an episode in the past or have closely related family members who have — as long as the surgi- cal team reviews early warning signs and response protocols before the procedure, moves an MH cart stocked with dantrolene into the OR, avoids the use of triggering agents, and closely monitors the patient's end-tidal CO 2 , minute ventilation and core body temperature during the procedure and throughout the recovery phase. 8. Which dantrolene option is best? The 3 available preparations (Dantrium, Revonto and Ryanodex) appear to be equally efficacious and have been used to successfully reverse MH episodes. The average dose 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 liver disorders of an idiosyncratic or hypersensitivity type may occur with dantrolene sodium therapy. To report SUSPECTED ADVERSE REACTIONS contact US WorldMeds at 1-888-900-8796 or MEDWATCH at 1-800-FDA-1088 (1-800-332-1088) or http://www.FDA.gov/medwatch/. To see the full prescribing information visit www.revonto.com. © 2017. US WorldMeds, LLC. Revonto is a registered trademark of US WorldMeds, LLC. REV-P91-0217 ® 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 and to see the full Prescribing Information. *from the date of manufacture † or until solution is clear