Outpatient Surgery Magazine

Special Edition: Staff & Patient Safety - October 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Y ou never know how your staff will respond to a rare but potentially deadly malignant hyperthermia (MH) event until it actually occurs. When we found ourselves facing a recent crisis, our staff stepped up in a major way — and what we learned from the incident could help your team's response efforts if they ever wind up in a similar situation. Like many MH emergencies, there weren't any early warning signs. From all outward appearances, the patient was the ideal candidate to anesthetize. At 22 years old, he was about to undergo surgery to remove a malignant scalp tumor. He was otherwise healthy, did not take any medications and had no allergies. It took about 45 minutes from the induc- tion of anesthesia to get the patient positioned and ready for surgery. Then it happened. Just before the initial skin incision was made, the patient started to develop seizure-like movements. His muscles became rigid, his heart rate increased suddenly from 70 to 120 beats per minute and end tidal carbon dioxide quickly rose from 35 mmHg to 70 mmHg. The anesthesia fellow noticed the early warning signs of MH and informed the staff anes- thesiologist, who was also present in the room. The staff anesthesiologist in turn confirmed the onset of MH and immediately started the treatment protocol for which our staff had been trained. I was called into the room, where I arrived within two minutes to find out my colleagues had already appropriately managed the situation. Timing is criti- cal any time an MH situation is in play. From the onset of the first sign of trouble until the first dose of dantrolene was given, it took only nine minutes 2 2 • S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 2 0 Carlos A. Ibarra Moreno, MD, PhD, DESA I Toronto GETTING PREPPED The entire surgical team at Toronto General Hospital readies dantrolene for administration. We Stopped an MH Crisis in Its Tracks Quick thinking and a well-trained staff allowed us to identify and prevent a malignant hyperthermia event in just nine minutes. All photos by Carlos A. Ibarra Moreno, MD, PhD, DESA

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