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Malignant Hyperthermia in ICU (Supportive measures (C - Support (ART line…
Malignant Hyperthermia in ICU
Supportive measures
A - Ensure airway secure
B - Hyperventilate for hypermetabolic syndrome and hypercarbia
C - Support
ART line and CVC
Ongoing Dantrolene administration
Cardiac monitor - prone to arrhythmia
D - sedation with non-triggering agents (at risk of permanent neuro injury, often from hyperthermia)
E - Measure core temperature
Ongoing active cooling (ice, fan, sponge, cold IV, cold bladder wash. Cool to btw 38-39 degrees
Electrolyte management - check K, CK and ABG
F - cold IV fluid - monitor urine output (probable myoglobinaemia)
H - Risk of DIC - monitor FBE and COAGS
Specific management
Dantrolene
Bolus 2.5mg/kg every 5 mins to max 10mg/kg
Half life 10 hours
Post incident follow up
Evaluation of susceptibility - muscle biopsy, DNA testing, screening relatives
Avoid future triggering anaesthetics