a cart in the ER and another cart in the pharmacy, a rover that can
respond anywhere in the hospital.
Each cart covers a territory that's listed on a laminated chart
attached to the cart. For example, the MH event happened in the ICU
so the ICU intensivist called the anesthesia tech in OR East to bring
over that MH cart. We update the anesthesia techs every year on
which cart responds to where in the facility.
Our MH carts are all set up the exact same way. Each drawer is
labeled clearly with what's inside. In the top drawer we keep all the
drugs and lab supplies. The test tubes needed for labs are separated
into Ziploc bags labeled 'mandatory' and 'optional.' In the other 2
drawers are supplies that anesthesia determined we needed, including
a bladder irrigation set, Foley catheters and esophageal sensors.
The cart also has a fridge on the bottom with cold saline, insulin and
cold packs. The cart is always plugged in when not in use and is
hooked up to a computer that monitors the temperature all day. It can
be unplugged quickly and wheeled down the hall during a MH crisis.
Once the cart is bedside, the circulating nurse starts assigning roles
like getting ice, inserting the Foley catheter and calling the MH hotline.
We noticed that during our MH drills things got pretty loud, so the carts
include laminated role cards attached to the side that she can just hand
out to people as they respond. As time is of the essence, she also assigns
multiple nurses to start mixing the dantrolene. On top of the cart is a
dosing chart that lists for a given patient's weight, the number of vials of
dantrolene we need to open, the amount of mg to give the patient and
the amount of dantrolene to administer once it's reconstituted.
The labs
Labs are a necessity during a MH crisis and you need the results STAT.
But it can be a process to order labs. You have to go through your
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