Malignant Hyperthermia
The location of the Malignant Hyperthermia cart.
What is the PACU?
A brief description of the patient's current condition. Includes the circumstances that caused your concern and prompted you to initiate communication.
What is situation?
The MD initiated protocol used if the patient is likely to need at least 6 or more units of PRBCs and is hemodynamically unstable.
What is Massive Transfusion Protocol?
The time during the surgical procedure when the specimen should be checked to ensure it is accurately labeled with the correct patient sticker and name of specimen.
What is the debrief?
The destination of properly labeled empty blood bags that are contained in a red biohazard bag after an MTP protocol.
What is the blood bank?
36 vials of this medication is stocked in the Malignant Hyperthermia cart (brand and generic name).
There is extra backup medication in the pharmacy.
What is Revonto (dantrolene sodium)?
Information about the patient such as age, diagnosis, current medical status, medical history, admission date, treatments received to date, relevant labs and other diagnostic tests.
What is background?
If a Consent for Blood Transfusion is not present on the chart and the patient does not wish to receive any blood products, this form must be present on the chart.
What is a Refusal of Blood Transfusion form?
Kidney stones and a specimen that is to be sent for frozen section should NOT be placed in this liquid.
What is formalin?
Two things that commonly trigger a Malignant Hyperthermia episode in susceptible individuals.
What are anesthetic gases and succinylcholine?
The reconstitution solution and amount used to mix each vial of dantrolene.
What is 60 ML of preservative free Sterile Water?
Head to toe clinical and physical evaluation and your impression of patient status.
What is assessment?
A blood sample that must be obtained and sent to lab prior to initiation of blood transfusion whenever possible.
What is a type and crossmatch?
Cytology specimens requiring cultures (such as fluid from lungs, ovarian cysts, urine, CSF, Pericardial fluid) are taken where?
What is: Taken to pathology department immediately?
MH-susceptible individuals have a genetic mutation that results in the presence of abnormal proteins in this part of the body. When exposed to a trigger, an abnormal release of calcium from this part of the body occurs causing sustained contraction, increased metabolism, and heat production.
What is muscle tissue?
The number of MG/KG used for the initial dose of Dantrolene.
What is 2.5? Up to 10 mg/kg.
This is followed by 1mg/kg every 4-6 hours for 24 hours or more if needed.
Professional opinion on how the patient's current situation should be addressed. Suggestions regarding plan of care.
What is recommendation?
______ is a trial transfusion done in a test tube to see exactly how your blood will react with potential donor blood.
What is Crossmatching?
Labeling specimens should include these 5 pieces of information
What is:
1. Patient's name
2. Date
3. Hospital number (on label)
4. Surgeon's name
5. Type/location of specimen
The first step in treating a patient with suspected MH crisis is to stop all anesthetics and administer this.
What is 100% Oxygen?
Typically, the first two signs of Malignant Hyperthermia.
What is tachycardia and increased ETCO2?
A bedside structured communication process that includes interactive communication allowing the opportunity for questioning between the giver and the receiver of patient information. Should be utilized during staff relief, Pre-op to OR, OR to PACU, and PACU to another care area to improve patient care.
What is Hand-Off Communication?
Two units of O negative PRBCs, labeled with an red label that states "Uncrossmatched", used when the patient's blood type is unknown.
What is Emergency Release Blood?
Specimens that are too large to be placed in a container of formalin (example: amputated limbs) should be placed in 2 heavy duty red bags, goose-necked, and delivered to this area in pathology to ensure preservation.
What is the PACU specimen room refrigerator?
Because of a genetic mutation that is inherited, certain geographic regions of the US have a higher incidence of MH families. Name one of the four states.
What is Wisconsin, Nebraska, West Virginia, or Michigan?