Malignant hyperthermia prevention and management protocol

Anaesthetic Safety

KEIT DAY HOSPITAL

Malignant hyperthermia prevention and management protocol

Official Manual of Clinical, Care and Organizational Protocols

1. Document Control Information

2. Scope of Application

Applicable to all patients undergoing general anesthesia and to personnel involved in the response to intraoperative emergencies.

3. Responsibilities

• Anesthesiologist: early identification, coordination of treatment and immediate clinical decision-making.
• Anesthesia nurse and operating room nurse: rapid preparation of dantrolene, logistical support and documentation.
• Clinical Directorate: maintenance of the minimum required stock and periodic staff training.

4. Operating Procedure

• Assess the patient’s personal and family history for features suggestive of malignant hyperthermia or unusual anesthetic events.
• Recognize suspicious clinical and monitoring signs at an early stage and declare the emergency without delay.
• Immediately discontinue potential anesthetic triggering agents and ventilate the patient with high-flow oxygen in accordance with the emergency anesthesia protocol.
• Administer dantrolene according to the current dosage and operational regimen, preparing additional doses when necessary.
• Treat hypercapnia, hyperthermia, acidosis, electrolyte abnormalities and hemodynamic complications according to the internal algorithm.
• Arrange intensive monitoring and, when necessary, transfer to a higher level of care.
• Document the event and inform the patient regarding future anesthetic procedures.

5. KEIT Operational Standards

• KEIT maintains a complete dose of dantrolene readily available as a patient safety measure.
• This emergency is included in the anesthesia team’s training and simulation programs.

6. Records and Documentation

• Emergency/MH cart checklist.
• Emergency medication register.
• Critical incident report.

7. Review and Updates

Verification of the required stock at least every six months and dedicated simulation exercises.

8. Related Attachments and Forms

• Operational checklists, recording forms, audit sheets and maintenance registers applicable to this protocol.
• Any department-specific or equipment-specific technical attachments are referenced in the relevant local operating instructions.

9. Final Approval