Download Week 9 Additional Study Guide for final exam

You will also have questions on the final exam about MH.
Malignant Hyperthermia (MH)
1. List the signs of MH.
2. What is the 1st thing to do if you suspect an MH crisis in during surgery? 3. What is
the 2nd thing to do if you suspect an MH crisis during surgery?
4. What medication is needed to treat MH and the dosage?
5. What do you use to dissolve or reconstitute a vial 20mg vial of Dantrolene?
6. What equipment and supplies do you use to cool a MH patient down?
7. Do you hyperventilate with 100% oxygen?
8. Is oxygen a medication?
9. Other signs of MH crisis include:
10. When do you begin administering Dantrolene?
11. What is the minimum amount of time after an MH crisis that a should a patient be
monitored?
12. What other medications may be given during treatment of an MH crises?
13. Which calcium is preferred?
14. Where does the patient recover after an MH crisis?
15. Do you continue to give Dantrolene post op?
16. How much Dantrolene do you give post-op?
17. What stat labs do you draw and monitor for an intraop and postop MH patient?
18. What IV lines are needed for an MH patient?
19. What anesthesia drug is high risk for and MH potential patient?
20. What other type of people are susceptible or at risk for MH?
21. How many vials of Dantrolene, minimum, do you need to have on hand for an MH
crisis?
22. Which volatile anesthetic gas has the highest risk for triggering MH?
23. Is an MH something you would call the MHAUS hotline and report?
24. Can you get telephone help from MHAUS during an MH crisis 24 hours a day?
25. Should a patient be referred to MHAUS if they are high risk for an MH crisis during
surgery?
26. What are 2 preop holding assessment questions the anesthesiologist may ask all
patients to determine risk of MH?
27. What anesthesia machine prep is needed? Make study notecard.
28. What other volatile anesthetics may also be triggers for MH but carry a minimal risk?
29. What is the definition of malignant hyperthermia?
30. Is Dantrolene a muscle relaxant?
Note:
While this condition often occurs in people without other serious medical problems,
certain inherited muscle diseases including: central core disease (abnormal curvature of
the spine (scoliosis); hip dislocation; and joint deformities called contractures; skeletal
muscle diseases such as: and multiminicore disease; Duchenne’s muscular dystrophy
(DMD) and Becker’s dystrophy (BD).
What is recommended to be stocked on an MH cart?
Drugs: dantrolene sodium IV (36 vials), sterile water (without a bacteriostatic
agent) to reconstitute dantrolene, sodium bicarbonate, furosemide, dextrose,
calcium chloride, regular insulin (refrigerated), and antiarrhythmics.
How should the anesthesia machine be prepared before surgery for an
MHS patient?
Ensure that anesthesia vaporizers are disabled by removing or taping in the “OFF” position.
Flow 10L/min 02 through circuit for at least 20 minutes. During this time a disposable,
unused breathing bag should be attached to the Y-piece of the circle system and the
ventilator set to inflate the bag periodically. Use a new or disposable breathing circuit. The
expired gas analyzer will indicate absence of volatile agents in the anesthesia circuit.
Changing the CO2 absorbent (soda lime or baralyme) is not recommended if these
procedures are followed. However, newer anesthesia machines such as the Drager Fabius
may require up to 60 minutes of preparation. Check with the manufacturer of the machine
for suggested washout procedure.
Also:
Either calcium gluconate or calcium chloride can be used to treat life-threatening hyperkalemia.
Gluconate (10-50 mg/kg) is less potent, but is less irritating to peripheral veins. The higher
potency calcium chloride (4-10 mg/kg) is more appropriate for the acute situation.