Every ASC needs a plan for managing malignant hyperthermia incidents, including protocols coordinated with area hospitals for transferring and handling MH patients, says a recent report by a panel of anesthesia experts.
The panel, made up of representatives from such organizations as the Malignant Hyperthermia Association of the United States, the Ambulatory Surgery Foundation and the Society for Ambulatory Anesthesia, published its report and recommended guidelines in the January issue of the journal Anesthesia & Analgesia.
Patients suffering the sudden onset of MH must be transferred to a hospital capable of providing critical care crisis management, the panel noted, but ASC staffs must also be prepared to take immediate action - namely, administering IV dantrolene - in their own ORs first.
The experts identified potential problems and treatments to consider in developing an MH response plan, including such key issues as the capabilities of the transport team and transfer hospital, indicators of patient stability, the decision to transfer and coordinating communications between facilities.
In addition, they suggested that ASCs might consider following up and reviewing any MH transfer events, quality improvement style, and that ASC anesthesia providers make contact with hospitals to ensure that their emergency department staffs are aware of and prepared for MH incidents.
"ASCs are so variable, so the guide is fairly general," says Marilyn Green Larach, MD, FAAP, senior research associate with MHAUS's North American registry, and the report's lead author. "An ASC may be virtually across the street from a hospital, versus another center that's 50 miles from the nearest hospital. One of the main thrusts of this effort was to prompt ASCs to develop their own transfer plan, taking into consideration what kind of resources they have and what emergency transport services are like in their areas."
Mark McGraw
