Malignant hyperthermia is a rare diagnosis, but nonetheless one worth being aware of. Very rarely, malignant hyperthermia may be triggered by succinylcholine, causing it to present initially in the emergency department or ICU. Far more often, malignant hyperthermia will be diagnosed in the operating room – with intensivists involved in providing follow-up care.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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Hi Josh, a few points to add for MH in the operating theatre:
– while implied by your point about hyperventilation, it is probably worth saying explicitly to turn off the volatile anaesthetic and remove the vaporisers
– as a corollary to this, you will often need to give a TIVA anaesthetic if surgery can’t be ceased urgently
– mixing dantrolene is hard work and will require multiple people assigned to this
– in Australia and NZ, a task card system (http://malignanthyperthermia.org.au/mh-task-cards/) is commonly included in the MH box/cart. This is an invaluable resource for team management in these crises