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Malignant Hyperthermia (MH) - Coggle Diagram
Malignant Hyperthermia (MH)
Causes
Anesthetics given to susceptible patient
Genetic skeletal muscle receptor abnormalities
Accelerated aerobic metabolism
increased CO2 and acidosis
Depleted O2 and ATP
Sustained muscle contraction
excess body heat
Presence of anesthetic causes excessive accumulation of calcium in the myoplasm
Collaborative Treatment
Call for MH Cart
Notify surgeon
Optimize oxygenation and ventilations
Increase rate of gas flow (displace anesthetic gas)
Place endotracheal tube
Use non-depolarizing muscle relaxant
D/C triggering agent (volatile anesthetic)
Administer Dantrolene
Monitor Labs, treat abnormalities
Hyperkalemia
calcium
Bicarbonate
Insulin-glucose
Metabolic acidosis
Cool as needed
Monitor urine output
Look for 1-2 mL/kg/hour
Risk Factors
Hypercarbia (Respiratory acidosis)
Tachycardia
Visible muscle rigidity
Labs/DIagnostics
Respiratory and/or metabolic acidosis
Hyperkalemia
from muscle breakdown
Elevated creatine kinase
Intravascular coagulation
Complications
Rhabdomyolysis
Atrial fibrillation
Disseminated Intravascular coagulation
DEATH
Clinical Manifestations
Tachypnea
Tachycardia
Muscle rigidity
masseter or generalized
(RARE) unexpected ECG indication of hyperkalemia
Hypercarbia (Respiratory Acidosis)
Arrhythmia
Hyperthermia
Myoglobinuria
Brown/cola/tea-colored urine
Due to rhabdomyolysis