March is Malignant Hyperthermia (MH) Awareness and Training Month, and Certified Registered Nurse Anesthetist (CRNA) Debra Merritt is reminding clinicians to be alert and prepared before a life-threatening crisis is triggered. The American Association of Nurse Anesthetists (AANA) has joined the Malignant Hyperthermia Association of the United States (MHAUS) in educating patients and healthcare professionals about the resources and guidance available for scientific understanding and optimum treatment of MH and related disorders.
MH is a rare, inherited syndrome that can affect patients who are receiving anesthesia for surgery or other procedures. It presents suddenly as an extreme metabolic reaction to various anesthetic gases and drugs. The signs of MH include muscle rigidity, rapid heart rate, high body temperature, muscle breakdown and increased acid content. Early recognition of an impending MH crisis and prompt emergency response are critical for a patient's survival.
"As an anesthesia or healthcare provider, knowing about MH is important to saving the lives of our patients," said Merritt, who is a member of the MHAUS Board of Directors. "MH raises many questions for patients and their families, so it's important for anesthesia professionals to be knowledgeable about the syndrome and be able to serve as a resource. Patient safety has always been the first priority for CRNAs."
During the preanesthesia patient assessment and evaluation, an MH screening can aid in determining a patient's risk for MH. If a patient is confirmed as MH-susceptible or has a family history of MH, proper anesthesia precautions must be taken throughout the anesthesia process, which includes induction, airway management, and emergence. These precautions include avoiding the use of volatile, MH-triggering anesthetic gases such as desflurane, enflurane, halothane, and sevoflurane, and the muscle relaxant succinylcholine. In addition, an activated charcoal filter should be used with the anesthesia machine.
In April 2015, the AANA Board of Directors adopted the position statement titled Malignant Hyperthermia Crisis Preparedness and Treatment, which contains the AANA's position on stocking dantrolene and considerations for MH policy development. Dantrolene is currently the only clinically accepted drug treatment for MH and is available in two formulations.
MH is an uncommon, potentially fatal condition. Anesthesia professionals may be the first to recognize the onset of an MH crisis, but a coordinated team response is vital in the effective treatment and management of MH. For emergencies only, call the MHAUS 24-hour MH Hotline at 1-800-644-9737.
For detailed information on MH crisis preparation, patient assessment, management, and transfer of care visit www.mhaus.org and the AANA's MH clinical resource webpage at www.aana.com/MH to access the position statement, articles, and other resources.
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