Originally Posted by Nitecap
what was the ck? what fluids where you giving? Any diuretics, lasix/mannitol? What were the routine dantrolene orders written for? How long are yall gonna continue the dantrolene for since they are at a strong risk to relapse.
If this had been the OR and happened under my care, the presentation would have been much better. I was an emergent consultant in this case, away from the OR.
A full set of labs, including myoglobin / CK / the works were obtained while I was there. The resident was in touch with the OR pharmacist concerning post-crisis dantrolene. Their conversation resulted in deciding to do a bolus of 1mg/kg every so many hours and not do a gtt. That was their conversation, I was not involved in it. My main portion of during this was giving dantrolene, starting initial labs, and active cooling.
This 4th year surgery resident involved had this happen about 3 months previous, in a post surgical patient, and he very good in this suspected MH crisis. He pretty much already knew the gameplan (so did I) and really didn't have to tell me to do anything. This happened in our best ICU as far as nursing staff go and they were on this like white on rice. I had some input on additional cooling therapies, ordered some labs for my intrest.
One hour into it, total dosage of 6mg/kg, a resolving temp and CV status - I'm out. The resident and his underlings were camping out up there with EXCELLENT nursing staff, my job was finished. They were all top notch. I gave him a box of dantrolene (6 vials), told him how many bottles a redose of 1mg/kg was, and how to mix it. I left the MH cart up there. Told him to give me a call if he needed anyone from anesthesia. Immediate crisis over, done deal.
Like I said, it was not my home.
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