Malignant Hyperthermia, non-anesthesia related

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Specializes in Cardiac, NICU, ED.

I admitted a patient last night from an outlying hospital with a diagnosis of malignant hyperthermia. Apparently, this was not anesthesia related. He had been extremely hyperthermic for a couple of days with no medications helping the temperature at all. Unfortunately I do not know much about the situation because I admitted him and another patient at the same time while also caring for 2 others. I had been unable to dig into the chart before he arrested about 4 hours after arrival. He was transferred after being revived briefly where he later arrested again and died in our ICU. This was my first patient arrest in my 8 months of being a nurse. I want to learn from this situation. Does anybody know what causes this when it is not anesthesia related? What are the common treatments? Since he had had a temp of greater than 105 degrees for a couple of days, he was 106 axillary on admission, was his brain function mostly already gone? A Dantrolene drip was ordered, however, had not arrived prior to his arrest. Thanks.

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Specializes in Cardiac Telemetry, ED.

My understanding is that people with the genetic capacity for MH can develop it after exercising or an episode of heat stroke, but that it is primarily triggered by exposure to certain anesthetics or succinylcholine.

What a sad situation! Was the person very young?

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Specializes in Cardiac, NICU, ED.

Yes, he was in his 50's.

The lack of responses to this post makes me think that this is extremely uncommon.

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Specializes in psych. rehab nursing, float pool.

It can happen with young athelete males who were given antipsychotic medications. It was rare. I saw it only once in 20 years of psych. The patient was in his early 20's and on Navane.

I had a 12 year old cousin who died from it. That was anesthesia caused. Poor kid was having a tonsilectomy.

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i thought to definitively dx malignant hyperthermia, a muscle bx was done?

otherwise, perhaps this pt was misdiagnosed?

one time i had a pt who the md dx'd w/malig hyperthermia, and as it turned out, he had neuroleptic malignant syndrome.,,

triggered by an abrupt withdrawal of his parkinson's meds.

just something to consider.

very sad, indeed.

leslie

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Specializes in Critical Care.

Why wasn't he on dantrolene prior to his transfer? It doesn't have to be a drip...

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Just a student but what about Kawasaki's disease, it usually affects children but not all of the time.

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I used to get folks pretty regularly from our affiliate acute psych hospital with NMS (neuroleptic malignant syndrome) from the use of psych meds.

Had another guy who had heat stroke and temp got to 108.

Lady who had a massive stroke and her temp also went up to 108. (both these patients died)

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Specializes in Pediatrics, ER.

Antipsychotics/neuroleptics are a common cause of NMS. Was this patient assessed for muscle rigidity/autonomic dsyfunction?

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