Outpatient Surgery Magazine

Manager's Guide to Surgery's Ambulatory Anesthesia - July 2015

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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J U LY 2 0 1 5 O U T P A T I E N TS U R G E R Y. N E T 2 5 stocked MH cart equipped with all necessary drugs and equipment to prevent and treat a crisis (see question 2 for more details). Perform a mock MH simulation drill annu- ally. As someone who's on the other side of the hotline, I can tell you that facilities that hold annual drills are noticeably calmer and more goal-directed during a real crisis. You can purchase MH simulation systems or simply create your own mock drill. Set aside part of a day and have your staff walk through responding to a patient experiencing symptoms of MH. Practice calling the MHAUS hotline and reconstituting expired dantrolene to get the full experience of an actual emer- gency response. During the mock drill, assign staff specific roles. If you work in a freestanding surgery center, establish a prearranged transfer plan to the closest hospital. Simply knowing which ER is nearby isn't enough. Communicate your plans with the nearest hospital and ensure that they have the supplies and capabilities to handle a transferred MH patient. 2. What supplies should always be on hand? The most important component is dantrolene. To treat an MH episode, an initial dose of dantrolene at 2.5 mg/kg is recommended. Since some MH patients may require as much as 10 mg/kg dantrolene at the start of an episode, we recom- mend having at least 700 mg available. Note, though, that this is based on an average patient weight of 70 kg, which is lighter than many patients nowadays. For Dantrium/Revonto, this translates to a minimum of 36 vials on hand. For Ryanodex, it's a 3-vial minimum. Additionally, dantrolene always requires sterile water for reconstitution. You also want to make sure your MH cart contains sodium bicarbonate, dex- Pamela Bevelhymer, RN, BSN z BE PREPARED Ensure you have enough dantro- lene, as well as cold saline, sterile water and other supplies, on hand to treat an MH episode.

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