Can I be a CRNA with Malignant Hyperthermia?

Specialties CRNA

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Hey all,

So I really want to be a CRNA - I love anesthesia, I find it extremely interesting, mostly due to the fact that I have an anesthesia related condition. The question is - can I actually be one with this condition? For those of you not familiar with it, with with malignant hyperthermia have an extreme reaction to anesthesia that causes tiny spasms in the muscles. The blood temperature sky rockets very quickly, enough to destroy organs in a short period of time. It takes a team of around 12-20 people to work an MH emergency - so it's a big deal. So if I have this, would there be a restriction in being a CRNA? Could I work with anesthesia if I, myself, could react to it?

Specializes in Cardiac, Pulmonary, Anesthesia.

I suppose you could go shadow and just have the dantrolene ready to find out!

Honestly, I agree with wtb. Consult the expert.

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Specializes in CRNA.
That's a question for your healthcare provider to answer.

I find this statement quite amusing. What do you think YOUR healthcare provider (FP or even internist) knows about MH? I guarantee you it is less than that of a first year SRNA or AA student.

Based on a recent event I was involved with regarding MH, it is quite surprising what little is actually known of this condition once you leave the OR.

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Wow, what a great question! Lots of opinions flying around on this one, but is there any evidenced based information out there to answer this question properly? The post about the MH association's stance seems to be the most research based answer so far. I'd call them and start there. It seems to me that based on the number of anesthesia providers out there vs the incidence of MH that if this were a huge concern, there would not only be documented cases of providers having MH attacks while administering anesthesia, but the issue would also be addressed more in all of our classes. It is definitely a fascinating question; please return and post any information you learn as you explore this.

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Specializes in Nephrology, Cardiology, ER, ICU.

Very interesting topic. Here's one answer:

Q: Can MH symptoms be induced by stress, overheating or excessive exercise?

A: The symptoms of heat exertion and heat stroke are remarkably similar to MH. However, the vast majority of patients who suffer heat-related illness are not MH susceptible. In a few cases, MH susceptibility has been diagnosed by muscle biopsy in patients who have suffered from heat stroke (non-fatal), and some experts believe heat stroke may occur more often in MH-susceptible individuals. This is an area of intense interest and investigation. The general advice for MH-susceptibles is to be prudent in their exposure to excessive heat and exercise in hot environments, although that same advice holds true for non-MH-susceptible patients.

Q: Are MH-susceptible individuals at risk for symptoms/episode if exposed to triggering agents while working in an operating room or similar environment?

A: There are no cases reported of MH patients having problems on exposure to waste anesthetic gases while working in the OR. The usual operating room procedures maintain low, trace amounts of the potent volatile anesthetics in the air. During a mask induction, someone within two feet or so of the face of the patient may be exposed to somewhat greater concentrations, but that is easily avoided. Further, the volatile agents are heavier than air and drift down to the floor, where the excellent ventilation systems efficiently clear the vapors.

Q&A: Malignant Hyperthermia

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There are no confirmed cases of OR workers developing MH, but the MHAUS site knows of at least one suspected or possible case due to OR exposure, didn't do a muscle biopsy. Just sayin

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You say you have this my question is how do you know? Did you actually have a MH event after anesthesia? That would be the major question to answer 1st. My advise would be to talk with an anesthesiologist get his or her input or a crna that has been in the field for a while.

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I have never heard of a single anesthesia provider going into MH, or any OR personnel. The occurence in the general population is extremely low, would make it hard to study to begin with. I couldn't find anything with a lit review on the subject either. I found it to be a very interesting question to think about. It is impossible to study the minimal amount of exposure required to illicit MH in humans though. Any answer you get would be an educated guess.

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If I were you I would find out my dibucaine number... Then do some communication with MHAUS and the aforementioned USHUS guru. The last person I would ask about this would be a FP. Or listen to any advice from anyone not in anesthesia.

Very interesting problem. Good luck.

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I, too am MH susceptible due to a strong family history. I have not had the biopsy. For the last 4 1/2 years, I have worked in surgery. On one occasion, when I worked in a room where we did several inhalation inductions, I developed an eye and jaw twitch. It went away by that evening.

When my eye started, I thought it wasn't that abnormal because my eye sometimes does that when I am particularly stressed. Then my jaw started twitching & I thought that I must have been under more stress than I was aware of. Later that evening I was telling my husband about it and noticed that the frequency of the jaw twitches had slowed down and were almost gone.

Am I certain it was MH related? No. Do I think there's a pretty good chance it was? Yes.

Before committing to a career (and spending all the $$) get a muscle biopsy.

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