1 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 1 7
be ready to spring into action when
seconds count and a patient's life
hangs in the balance.
What better way to assess your staff's
baseline understanding of MH than
with a quiz? Based on how well your
team scores, you can tailor your subse-
quent training to fill in identified knowl-
edge gaps. (Quick tip: Have each staff
member identify their quiz with a
unique symbol, so they can view their
corresponding scores anonymously
when you post the results.) Here's a variety of ques-
tions to consider asking:
• What causes MH? MH is a rare genetic disorder marked by severe respons-
es to anesthesia. Not all anesthetic agents will trigger susceptible patients.
Some, though, like isoflurane, desflurane, sevoflurane, and the muscle-relaxant
succinylcholine, can cause life-threatening reactions.
• What are the early warning signs? Your staff should be able to recognize
changes in a patient's condition that indicate the onset of an episode, including
muscle rigidity, flushed skin, rising end-tidal CO
2
, tachycardia and rapid breathing.
MH can strike at any time in anesthetized patients, including when the patient is
in recovery, so recovery area nurses should be aware of the possibility and remain
vigilant.
• What are the treatment options? Three formulations of dantrolene, which
specifically combats muscle contractions caused by MH, are currently available:
Dantrium, Revonto and Ryanodex. Dantrium and Revonto come in 20 mg vials
and require 60 ml of sterile water for reconstitution. Ryanodex, a newer formula-
tion, comes in 250 mg vials and should be reconstituted with 5 ml of sterile
water. You must stock 36 vials of Dantrium or Revonto. You only need to stock 3
DO YOUR JOB Assignment cards tell staff
members where to be and what to do dur-
ing each phase of an emergency response.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
