rapidly increasing heart rate, the numbers climbing in concert with
the thump, thump, thumping of his own chest.
It's happening.
"We've got an MH event on our hands," he calls out, calmly but
forcefully. "Let's move, people. This is the real deal."
How long would it take for your team to roll an MH cart into the
room, open its drawers and pull together the supplies needed to recon-
stitute dantrolene, the one drug that can save the patient's life? The dif-
ference between pats on the back for a job well done and a long walk
to the waiting room could literally depend on how often you make
sure your MH cart is fully stocked and properly organized.
Taking stock
Anesthesia providers at Children's Hospital Medical Center in Omaha,
Neb., fill the top drawer of their MH carts with medications needed
during an emergency response. "Dantrolene is right there, ready for us
to start mixing and give right away," says Ryan Hamlin, MD, clinical
director of pediatric anesthesiology and a consultant for the hotline of
the Malignant Hyperthermia Association of the United States
(MHAUS). He points out that there are 2 formulations of dantrolene
on the market:
• Dantrium (Par Pharmaceutical) and Revonto (US WorldMeds)
come in 20 mg vials that require 60 ml of sterile water to reconstitute.
You must stock 36 vials of each formulation, which have shelf lives of
3 years, at a cost of $2,340 for Dantrium and $2,400 for Revonto. Your
staff must reconstitute 8 vials of either medication to deliver the initial
2.5 mg/kg dose that's needed to stabilize a stricken patient.
• Ryanodex (Eagle Pharm-aceuticals) comes in 250 mg vials that
require
5 ml of sterile water to reconstitute. You must stock 3 vials
of the drug, which has a shelf life of 33 months, at a cost of $8,134. The
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