1.3.1 MH Crisis Management

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Co-ordinator’s * Overview

  1.   Check that Vaporiser removed from machine
  2. Check Fresh Gas Flow > 15L/min
  3. Hyperventilate with 100% O2

 

mh-overview

* In most cases it is expected that the co-ordinator will be “Anaesthetist 1”

The following are the recommended contents of an MH Box

Dantrolene

  • 24 x 20 mg vials of Dantrolene
  • Sterile water for injection (2000ml) clearly labelled as unsuitable for IV infusion
    • eg 250 ml bag from B/Braun or 100ml bottles of sterile water for parenteral injections (Pfizer)
  • Drawing up needles
  • 60 ml syringes 5-10

Include information on where to obtain additional dantrolene   

Drugs:

  • 8.4% sodium bicarbonate (1mmol/ml)
  • 50% dextrose 50 ml
  • Lignocaine 1%
  • Amiodarone 300mg

Cold Box in fridge:

  • 2 litres normal saline for IV use
  • Actrapid insulin

Blood tubes for:

  •  Haematology, coagulation profile
  • Electrolytes, creatinine, urea, creatine kinase (CK)
  • Crossmatch
  • Blood gas syringes
  • Urine sample pot for myoglobin
  • Pathology forms (pre-written)

Task Cards:

As described in the MH Resource kit instructions

If space in your MH Box allows: (otherwise, have instructions on where to find)

Urinary catheter:

Urinary catheter and hourly urine bag

Monitoring equipment: 

Arterial line equipment  Central line catheter