Signs and Symptoms
Medication Management
Priority Actions
Resources
Miscellaneous
100

What are some of the EARLY signs of an MH crisis?

  • Unexplained tachycardia or arrhythmias (usually ventricular tachycardia and premature ventricular contractions)
  • Hypercarbia (increased end-tidal carbon dioxide [ETCO2] level)
  • Tachypnea (if breathing spontaneously)13
  • Hypoxemia
  • Masseter muscle rigidity after a triggering agent (commonly the administration of succinylcholine)
  • Profuse sweating and mottling of the skin
  • Acidosis
  • Generalized muscle rigidity
100

What is the drug do we at Sacred Heart give during an MH crisis?

Ryanodex

100

What is the first thing the RN should do during an MH crisis?

Call for the MH cart and assistance

100

Where is the MH Cart located?

By the Case Cart Room

100

This is the primary electrolyte thought to contribute to an MH crisis.

Calcium
200

What are some late signs of an MH crisis?

  • Temperature elevation (can increase 2° F [1° C] every few minutes)
  • Hyperkalemia
  • Cyanosis
  • Coagulopathy (disseminated intravascular coagulation)
  • Rhabdomyolysis
  • Myoglobinuria (causing dark-colored urine)
  • Kidney failure
200

What is the mixing agent for Ryanodex and how much do you add

5ml of preservative free sterile water

200

What is the scrub person's first action during an MH crisis.

Communicate with provider and assist with rapid closure. Ioban over incision to maintain sterility.

200

What is the group you can call for MH assistance?

MHAUS

200

How often does the MH cart need to be checked? 

Daily

300

What puts someone at risk for having an MH crisis?

Immediate blood-related family member having the same reaction

300

What is the dosage for Ryanodex

2.5mg/kg

300

RN should confirm what with anesthesia?

The triggering agent has been discontinued and charcoal filters have been applied.

300
What are the hours for the MHAUS hotline?

24/7

300

What lives inside the MH Cart?

Top of cart: Dosing chart, charcoal filters, daily check off list and stocking list 

First drawer: IV start supply, art line, lab tubes and Ryanodex vials and reconstitution supplies 

Second drawer: Urinary catheter kit, pediatric urinary catheters and single use ice packs. 

Refrigerator contents: 2- 1,000 mL saline irrigation bottles, 2 - 1,000mL IV saline bags 

Attached to cart: MHAUS poster, Role cards

400

Name some drugs that can induce an MH crisis. 

Common inhaled general anesthetic agents, such as halothane, sevoflurane, desflurane, isoflurane, and enflurane as well as the muscle relaxant succinylcholine

400

How many mg would you give of Ryanodex to a patient weighing 75kg? 

187.5 mg of Ryanodex 

400

These can be placed in the axilla or groin to slow the hyperthemia

Cold packs.

400

This group can be called for assistance during an MH crisis after-hours

Code team

400

What can the ST do to help decrease the patient's temperature?

Apply cold irrigation to the field. 
500

How long after exposure to anesthetic agent can an MH crisis occur?

MH may occur upon initiation of anesthesia, in the middle of a case, or up to one hour after the end of an anesthetic.

500

Who should you call to get additional Ryanodex?

Pharmacy

500

This type of communication is helpful to prevent confusion and ensure tasks are completed.

Closed-loop communication

500

MHAUS hotline phone number

800-644-9737

500

What surgical scheduling considerations should be made for a patient with a known MH risk?

Schedule for the first case of the day.

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