[BSNDec06]

I was told by one of the PACU nurses the other day that the risk for development of malignant hyperthermia extends to 2 hours post-op. This patient had a family (but not personal) history of MH. In recovery they had been taking a temp every fifteen minutes as a precaution. I continued to do so for the first hour that my patient was on the floor, but I question whether this was necessary.

Can anyone provide me (a floor nurse) with some guidance with regards to this type of situation? TIA

[ready4crna?]

Check out the mhaus website for authoritative info about mh.
http://medical.mhaus.org/PubData/PDF...mentposter.pdf

[imenid37]

Here are two good websites re. MH.
http://www.thomasjeffersonuniversity...ticle3528.html
http://www.mhaus.org/

I bet the CRNA's on the board would have some good info. for you.

[TheOldGuy]

Was the pt given prophylactic dantrolene?

[peddler]

HR and RR would have been better vitals to closely monitor as temp is usually a late sign. The family Hx of MH triggered many red flags in the OR and i bet the depolerizing agents that cause MH were nowhere near the room.

[dfk]

Originally Posted by BSNDec06

I was told by one of the PACU nurses the other day that the risk for development of malignant hyperthermia extends to 2 hours post-op. This patient had a family (but not personal) history of MH. In recovery they had been taking a temp every fifteen minutes as a precaution. I continued to do so for the first hour that my patient was on the floor, but I question whether this was necessary.

Can anyone provide me (a floor nurse) with some guidance with regards to this type of situation? TIA

i can assure you it is necessary.
some monitor for atleast up to 4 hours post-op
trust me, when you have an MH reaction, you will NEVER question the severity or rapidity of it all !

[BSNDec06]

Originally Posted by TheOldGuy

Was the pt given prophylactic dantrolene?

No, not as far as I know...

[merlebo02]

MH can happen as much as 36 hours after surgery!!! I have read and been taught that prophylactic dantrolene does not improve the outcomes and should not be used. The pt should definetly be monitored very closely paying close attention to CO2 as it is the first thing to go up. If MH is suspected pt should be given 100% 02 atleast 10L/min, dantrolene 2-10mg/kg (needs to be continued after started for 36 hrs given every 6hrs), may need ice packs under arm pits, under knees, around neck, and may need to give sodium bicarb in that it will cause acidosis. You will also need to start some fluids to keep the kidneys flushed in that kidney failure could develop. Also will want to watch the K level in that it will go up. If there is a pt/family hx of MH a pt can still have surgery just dont need to use volatile anesthetics or SUCC's, with this known MH alot let common.

AM I ON TRACK, what else should or should not be added

[BULLYDAWGRN]

we had a mh patient about 6mos ago. 24yo asian post lap chole. patient did get sux.. hr started to climb into the 140's and even a few runs of svt.. started dantrolene in paccu and rush to icu. for the 1st 6hrs we did nothing but watch retal temp, placed a-line, cooling blanket, fluid bolus after bolus watched myoglobin in urine. gave multiple more doses of dantrolene. temp got as high as 103.8... but within 12hrs post admit he was very much a & o x3. luckily he recoverd well.. but needless to say i've never seen so many mda's in the unit at one time. but the best course of action is to call the malignant htn hotline number, they'll basically talk you through.

[dfk]

Originally Posted by BULLYDAWGRN

we had a mh patient about 6mos ago. 24yo asian post lap chole. patient did get sux.. hr started to climb into the 140's and even a few runs of svt.. started dantrolene in paccu and rush to icu. for the 1st 6hrs we did nothing but watch retal temp, placed a-line, cooling blanket, fluid bolus after bolus watched myoglobin in urine. gave multiple more doses of dantrolene. temp got as high as 103.8... but within 12hrs post admit he was very much a & o x3. luckily he recoverd well.. but needless to say i've never seen so many mda's in the unit at one time. but the best course of action is to call the malignant htn hotline number, they'll basically talk you through.

i'm sure this was more for the ooohs and aaaahs of never seeing MH rather than chipping in type stuff... !