Anesthesiology High Reliability Organization develops a scenario
where a team is in the middle of surgery and the patient begins devel-
oping signs of MH. We do the drill in the OR and use a mannequin or
one of the OR personnel if the mannequin isn't available. We have to
make it as real as possible.
Staff roleplay as the people who'd respond to a MH event — the OR
circulating nurse, the surgical scrub RN or tech, CRNA, anesthesia
tech and surgeon. The OR circulating charge nurse assigns roles to the
different OR personnel — a few to mix the dantrolene, someone to get
the ice, someone to insert the Foley tube, someone to pretend to call
the MH hotline. Of course every drill results in an excellent outcome.
We debrief at the end and give all a chance to ask anesthesia questions.
We've refined this protocol year after year. After we drill, we talk
about what went well and where we can improve. If there are areas of
concern, we adjust the protocol to address them. We all do better in a
crisis with a standard protocol to follow. We've updated our checklist
3 times, but the basic protocol hasn't changed: assess, get the cart,
know your role and stabilize the patient.
OSM
4 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
Ms. Bradley (colleen.bradley@unchealth.unc.edu) is a staff nurse at UNC REX
Hospital in Raleigh, N.C. She is the designated MH leader and led the MH initia-
tive for the OR and hospital-wide protocols.
