Archive Staff & Patient Safety 2017

Make MH Drills Count

Realistic practice sessions could someday prove to be life-saving exercises.

Margaret Thomas

Margaret Thomas, MSN, BS, RN, CNOR

BIO

hand-on HANDS-ON APPROACH Using expired vials to practice reconstituting dantrolene adds realism to drills and familiarizes staff with the time-sensitive task of preparing the drug for administration.

Today might be the day you get called into the OR to help save a patient stricken with malignant hyperthermia. Does that thought fill you with a jolt of panic or calm confidence in knowing your staff will be well on their way to stabilizing the patient by the time you arrive?

It's estimated that malignant hyperthermia occurs once in every 100,000 surgeries, but don't let that low incidence rate fool you. MH can strike at any time, without warning, and when it does, it comes on quickly and progresses even faster. Your surgical team must react like seasoned professionals who've responded to MH before and know precisely what to do and where to be in an emergency. If you conduct regular and realistic MH management drills, they'll be ready to spring into action when seconds count and a patient's life hangs in the balance.

What better way to assess your staff's baseline understanding of MH than with a quiz? Based on how well your team scores, you can tailor your subsequent training to fill in identified knowledge gaps. (Quick tip: Have each staff member identify their quiz with a unique symbol, so they can view their corresponding scores anonymously when you post the results.) Here's a variety of questions to consider asking:

What causes MH? MH is a rare genetic disorder marked by severe responses to anesthesia. Not all anesthetic agents will trigger susceptible patients. Some, though, like isoflurane, desflurane, sevoflurane, and the muscle-relaxant succinylcholine, can cause life-threatening reactions.

What are the early warning signs? Your staff should be able to recognize changes in a patient's condition that indicate the onset of an episode, including muscle rigidity, flushed skin, rising end-tidal CO2, tachycardia and rapid breathing. MH can strike at any time in anesthetized patients, including when the patient is in recovery, so recovery area nurses should be aware of the possibility and remain vigilant.

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