TYK125
Which of the following statements is true regarding management of an acute episode of MH?
a) Reconstitute dantrolene in normal saline and administer at 2.5 mg/kg intravenous over 5 minutes to maximum dose of 10 mg/kg
b) Active cooling is indicated if core body temperature is > 39 degrees Celsius with ice packs in axilla and groin, intravenous cold saline solution or cold saline lavage to a core temperature of 36 degrees Celsius
c) Correct metabolic acidosis with intravenous sodium bicarbonate 1-2 mEq/kg as needed
d) Discontinue inhalation anesthetic and hyperventilate the patient using the same anesthesia breathing system without any charcoal filter
Answer
Answer c.
Any metabolic acidosis should be corrected with bicarbonate. Dantrolene should be reconstituted in sterile water and not normal saline. In case of hyperthermia (core temperature > 39 C) active cooling should be done to a core temperature of 38 C. Discontinue inhalation anesthetic and hyperventilate the patient with gas flow greater than 10 L/min of 100% oxygen. Place charcoal filter on inspiratory and expiratory limbs of the breathing circuit or replace the exposed elements of anesthesia breathing system or use a new non-rebreathing system.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.
- See also MHAUS
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