Archive Anesthesia 2018

How to Organize Your MH Carts

Standardized supplies will help your staff save a life when every second counts.

Cheryl Gallaga

Cheryl Gallaga, MSNEd, RN, CNOR


GRAB AND GO Staff are able to quickly and confidently respond during an emergency response if they know exactly where supplies are located.

Malignant hyperthermia can strike at any time in any patient, but realistic drills and quick recognition of muscle rigidity or uptick in core body temperature won't make a bit of difference if your surgical team is rummaging around the drawers of the MH cart in search of dantrolene, the life-saving reversal agent, and the supplies needed to administer it.

Our MH carts, however, were overstocked and cluttered, potentially making them harder to navigate in an emergency. The supplies and materials were also inconsistent. Supplies would often expire without us knowing. Perhaps the biggest issue: A nurse would have to open 3 drawers to grab the items needed to reconstitute dantrolene. When minutes matter in an emergency, an organized response with organized supplies can mean the difference between life and death.

When our rapidly growing healthcare system expanded to add 4 separate procedural areas where anesthesia would be administered, we added 4 additional MH carts. All of the carts were stocked according to the Malignant Hyperthermia Association of the United States (MHAUS) resources ( However, each new cart was a little bit different than the others. Our hospital brought together a team of staff from each of the 5 clinical areas to develop standardized carts that would be used throughout the health system. Here's how we reevaluated and restocked each cart.

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