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S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U LY 2 0 1 4
Ready for action
Can you guarantee your staff won't face an MH emergency on your watch? No.
But you can ensure they're prepared if an event strikes.
• Practice response protocols.
"Drill, drill, drill," says anesthesiologist Andrew
Herlich, DMD, MD, FAAP, professor and vice chair for faculty development at the
University of Pittsburgh School of Medicine, who volunteers his services to the
Malignant Hyperthermia Association of the United States (see
"Answering the
Calls for Help").
Don't run through the motions. Make your practice runs as realistic as possible.
As Ms. Clifford's experience shows, staff who know exactly what to do are able to
respond quickly and save lives.
Conduct mandatory annual MH drills for the entire surgical team, including
anesthesia providers. Use expired dantrolene so staff feels what it's like to recon-
stitute the rescue agent with bucket-brigade-like precision. Clearly communicate
your expectations, even if requests or responsibilities might seem obvious.
Ms. Clifford's surgery center has a limited supply of ice, but it sits on a hospi-
tal campus. "We had arranged with the dietary office years ago to make sure
they responded in a timely manner if we called for ice," she explains. When the
shoulder surgery patient became stricken, a food-service employee arrived
quickly, but with only 2 small bags of ice, enough to spread on a sprained ankle.
"Now, whoever makes the call for ice clearly states where it's needed, and that
it's for a patient-life event," says Ms. Clifford.
• Recognize warning signs.
A panel of 13 MH experts published a guide in the
January 2012 issue of Anesthesia and Analgesia (
tinyurl.com/ova9xpf
) that
included key warning signs of an event and tips for transporting patients from
surgery centers to hospitals for timely follow-up care and improved outcomes.
The guide tells you to look for elevated ETCO
2
, muscle rigidity, hyperthermia,
acidemia/acidosis and myoglobinuria during exposure to triggering agents —
sevoflurane, desflurane, isoflurane, halothane, enflurane, methoxyflurane and
succinylcholine.
P A T I E N T S A F E T Y
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