Treatment is predicated upon preparation for a rare event. Every anesthetic must be associated with a plan for treatment of unanticipated MH. With the plan in place, treatment can be prompt and lifesaving. Prompt recognition of the signs of MH is essential to an optimal outcome. Preparedness is essential to prevent death from MH.
In addition to an anesthesia machine (if used), ECG monitor, pulse oximeter and capnometer, all locations where general anesthesia is administered should contain:
- A plan to treat MH, such as the poster and MH Procedure Manual available from MHAUS. For immediate emergency consultation with a volunteer anesthesiologist MH Hotline consultant, contact the MH Hotline.
- A means to continuously monitor end-tidal carbon dioxide levels, blood oxygen saturation and core body temperature.
- A means to actively cool a patient; e.g., a hypothermia blanket(s) (over and under the patient) and a refrigerator containing cold isotonic saline for IV infusion and for gastric, peritoneal or rectal irrigation, as appropriate. Ice is much more effective at cooling, though core cooling using iced saline intravenously may be effective (0.5°C. /liter in a 70 kg adult). The volume of IV saline that should be rapidly infused limits maximum effect.
Beware of unintentional hypothermia! Stop cooling measures when temperature falls to 38°C
An MH cart or kit containing the required drugs, equipment, supplies and forms should be immediately accessible to operating rooms.