Malignant Hyperthermia
Malignant Hyperthermia Occurs more frequently in:
a. children and elderly patients.
b. young adults and elderly patients.
c. children and young adults.
c. children and young adults
Stand up and show us your best dance move.
Where is the Emergency Preparedness Manual located?
In each department and on the TCMH (p:) drive. Our department's manual is located in Recovery/Preop.
Where are the MSDS sheets located?
In Pre-op/Recovery by the file cabinet/desk.
Show us your best impersonation of an opera singer.
Bronchoscopy: Respiratory, GI, GU tracts entered, controlled, no unusual contamination
Clean, Clean-Contaminated, Contaminated, or Dirty?
Clean-Contaminated
Vicryl is a/an ________ suture.
a. absorbable
b. non-absorbable
a. absorbable
Stand up and say the Pledge of Allegiance
Which one of the following agents can trigger an MH episode?
a. Narcotics
b. Succinylcholine
c. Ketamine
d. Propofol
b. Succinylcholine
Isoflurane, Sevoflurane, Desflurane, Halothane, Enflurane, and Methoxyflurane are other possible triggering agents.
If Registration pages a "Code Red" overhead, what does that mean? Give some examples of what you would do.
Code Red means there is a fire. In the event of a real fire, you should:
Be aware of the Hospital Evacuation Plan
Close all doors and windows
Inform patients and visitors
Count the number of patients, visitors, and employees and report to incident command
Make sure the magnet is changed to it's proper color (green if all clear, red if still occupied).
Help get everyone to safety.
Where is the Trach Tray located (in our department)?
In the bottom cabinet in Room 1
Mastectomy: Uninfected, no inflammation, closed primarily
Clean, Clean-Contaminated, Contaminated, or Dirty?
Clean
What is the appropriate temperature range in the OR?
a. 67-72 degrees
b. 68-74 degrees
c. 63-78 degrees
d. 68-73 degrees
d. 68-73 degrees
True or False:
Surgery cannot be safely performed on MH susceptible people.
False. MH susceptible patients may undergo surgery-inpatient or outpatient. Dantrolene is not necessary preoperatively. Malignant hyperthemia can be avoided by eliminating triggering agents. Just because a patient is susceptible, doesn’t mean their case has to be cancelled.
If we hear "Security Alert! Infant/Child Abduction" followed by a description of the abductor, what should our department do?
Go to our department's designated Exit areas and watch for anyone with a similar description of the abductor or anyone acting suspicious. Call 911 if you come into contact with the abductor and have critical information.
Where are the bi-polar bayonette forceps located?
In the clear tub with Podiatry equipment.
Show us your best impersonation on calling a pig. Suuuuu-ey!
Inflamed Appendix: Acute nonpurulent inflammation
Clean, Clean-Contaminated, Contaminated, or Dirty?
Contaminated
Try your best attempt at the "Carlton" dance.
What is the appropriate humidity for the OR?
a. 25-60%
b. 20-60%
c. 20-65%
d. 25-65%
b. 20-60%
Slow dance with an imaginary person, an inanimate object, or a person of your choice.
Each vial of dantrolene is reconstituted with 60 ml of this.
Preservative free sterile water
Do your best impersonation of a yodel.
If there is a security alert for a combative patient, who should respond?
S.T.A.R.R. Trained Personnel should respond, and then Law Enforcement will take over as soon as they arrive.
Sing a whole lyric from the first song you can think of.
Where are the Mesher and Dermatome located?
In Room 3 in the far left cabinet. It is in the big clear labeled plastic tub.
Draw a self portrait.
Splenectomy: Un-infected, no inflammation, closed primarily, but the case had a major break in sterile technique.
Clean, Clean-Contaminated, Contaminated, or Dirty?
Contaminated
To quickly sterilize an instrument for immediate use (in an emergency situation), which setting should the little autoclave be on?
a. P08 VAC 4 AND 20
b. P08 VAC 4 AND 15
c. P02 VAC 4 AND 2
d. P08 VAC 4 AND 30
c. P02 VAC 4 AND 2
Five signs/symptoms of MH
Dramatic rise in body temperature, sometimes as high as 113 degrees Fahrenheit (Temperature can increase 1.8 degrees Fahrenheit every 3 minutes)
Muscle Rigidity, Masseter Spasm
Flushed skin
Sweating
Tachycardia: abnormally rapid or irregular heartbeat
Tachypnea: rapid breathing, causing increased C02 Production
Left ventricular failure - pulmonary edema - death
Hyperkalemia: high levels of potassium. Too much potassium in your blood can lead to dangerous changes in heart rhythm.
Rhabdomyolysis: syndrome due to a direct or indirect muscle injury. It results from the death of muscle fibers and release of their contents into the bloodstream. This can lead to serious complications such as renal failure.
Brown or cola-colored urine
Very low blood pressure (shock)
Confusion
Muscle weakness or swelling after the event
What do the acronyms RACE and PASS mean?
R-Rescue A-Alarm C-Contain E-Evacuate
P-Pull A-Aim S-Squeeze S-Sweep
Pull from the bag of dares! If you refuse to do it, lose 500 points.
Where is the Dantrolene located?
On the Malignant Hyperthermia cart in Recovery/Pre-Op.
Wound debridement, positive cultures pre-op
Clean, Clean-Contaminated, Contaminated, or Dirty?
Dirty
Grab a "microphone" of your choice and sing Sweeeeeeeeet Caroline...Duh Duh Duhnnnn.
Perioperative Personnel should assess for risk factors associated with patient positioning. Give 3 examples of risk factors.
Advanced age, height and weight, body mass index, skin condition, poor nutritional status, hx of smoking, allergies (eg.,latex), preexisting condtions: vascular, respiratory, circulatory, neurological, immune system suppression, arthritis, diabetes, jewelry, piercings, prosthetics, implanted devices, external devices, anesthesia: perception of pain, level of consciousness, length of procedure, psychosocial and cultural considerations