Malignant Hyperthermia (MH) Nursing Interventions for Certified Perioperative Nurse (CNOR)

Malignant Hyperthermia (MH) Nursing Interventions

Guidelines:

• Often fully identified post-op
• Triggers
  • Anesthetic gasses (“ane”)
  • Succinylcholine
  • Unknown
• Rhabdomyolysis
• Family history, muscle biopsy
• Previous exposure does not guarantee safety
• DANTROLENE
  • MH cart
  • Cold IVF
  • Ryanodex (brand name, $$, important to know which you have)

Considerations:

• Recognize-act
• Rising-etCO2
  • fighting vent settings
• Tachy
• Acidotic
• “Marathon”
• Hyperthermia
  • could be late
• Rhabdo- late sign
• Rigidity- masseter typically visible
• 1:100,000, 2:1, m:f
• MH chart checks
• Training!
• DIC late sign, with end stage organ fail

Nurse’s role:

• Nurse’s role
• Awareness/identification
• Dantrolene party
• Screening
• Labs/foley/ICU

Pitfalls:

• Failure to identify
• Statistical probability dismissal
• Previous exposure
• Low volume high risk
  • Cart
  • Training

Examples:

• Pt arrived in PACU,tachy, hypertherm, rigid, arrhythmia (suspect MH, activate protocol, Anes stat, dantrolene party)

Linchpins (Key Points):

• MH must be identified and treated quickly, butthe low frequency makes this treatment particularly high risk