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nurses and surgical techs took on their own responsibilities. Here are some sug-
gestions for how to divvy up the assignments:
• Surgeons should end the procedure as quickly as possible and help with
response protocols.
• Anesthesia providers should discontinue inhalational agents, hyperventilate
the patient with 100% oxygen, lavage the patient with cool saline solution and
oversee the response efforts.
• Circulating nurses can ask for help from all available employees, retrieve the
MH and crash carts, prepare dantrolene for administration, assist the anesthesia
provider in treating secondary symptoms — including metabolic issues such as
acidosis, hyperkalemia and rhabdomyolysis — and patch the OR through to the
MHAUS hotline (800-644-9737).
• OR nurses can assist in reconstituting dantrolene and call 911 to get the sta-
bilized patient transferred to an intensive care unit as quickly as possible.
• Surgical techs and additional staff members can retrieve and restock bags
of ice that are used to cool the patient, and support other members of the
response team as needed.
Discuss as a group how to reconstitute dantrolene, where to obtain bags of
ice to pack around the patient, how to properly document an event and the pro-
tocols for working with responding emergency medical technicians to transfer
patients to a local hospital for follow-up care. MHAUS can also be a valuable
resource during your team's drills. We called the hotline during our practice ses-
sion and listened as one of the organization's experts helped walk us through
proper response protocols and answered questions we had during the exercise.
With the expert's steady pacing over the 15-minute exercise and reiteration of
how and when to run the commands noted on the script cards, our first drill
went off as smoothly as possible.
Reconstituting dantrolene quickly and efficiently was a particular challenge
for our team. Revonto and Dantrium expire in 36 months, and Ryanodex expires
in 24 months, so we used outdated vials to provide staff with the opportunity to
