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Malignant Hyperthermia Crisis - AAGBI

1 Recognition Unexplained increase in ETCO2 AND Unexplained tachycardia AND Unexplained increase in oxygen requirement Previous uneventful anaesthesia does not rule out MH

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	u  U
u  Install vlean lreathing system and 
u Maintain anaesthesia with intravenous agent
u Musvle relaxation with non-depolarising neuromusvular llovking drug
  vasovonstrivtion
 valvium   
   vhloride, gluvose/insulin, NaHCO
  u  
        
   magnesium/amiodarone/metoprolol
   
   interavtion with dantrolene
  u  
   NaHCO
  u  
   diuresis (mannitol/furosemide +  
   NaHCO
¯); may require renal   
   replavement therapy later
  u 
 20mg (eavh vial mixed with 60ml  
 sterile water)
Further loluses of 4 vials   
 dantrolene 20mg repeated up to 
 7 times.  
   
u Continue monitoring on ICU, repeat dantrolene as nevessary
u Monitor for avute kidney injury and vompartment syndrome
u Repeat CK
u Consider alternative diagnoses 
u Counsel patient e family memlers
u Refer to MH unit (see vontavt details lelow)
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