Temperature Monitoring Important for MH Detection!
The June 2015 edition of APSF, The Official Journal of Anesthesia Patient Safety Foundation, has a great article titled, what’s your MH IQ? When I received this journal the first thing that came to my mind was MH, Malignant Hyperthermia? That is so 20 years ago! But after reading the article I realized my MH IQ also required updating. MH is still prevalent and patients still die from MH. Even with Dantrolene readily available to administer, MH is often caught too late. The article discusses MH misconceptions, one of them being that fever is a late finding of MH suggesting than Anesthesia Care providers think “Fever is a late finding in MH crisis. If we take measures to keep patients warm, temperature monitoring is unimportant.” (http://www.apsf.org/newsletters/html/2015/June/01_MHIQ.htm) As the article clearly states, fever is actually one of the three (3) early warning signs of an MH episode. Thus, continuous monitoring of the patients core body temperature is an extremely important parameter to monitor during general anesthesia. Currently available standards and guidelines for patient temperature monitoring during anesthesia suggest:
Standards Temperature Monitoring
- SCIP-Inf-10 “Measure: Surgical patients should be actively warmed during surgery or have at least one recorded body temperature equal to or greater than 98.8 degrees Fahrenheit within 30 minutes prior to the end of anesthesia to 15 minutes after anesthesia ends. (Patient’s with intentional hypothermia are excluded from this measure.)”
- ASA Standards for Basic Anesthesia Monitoring
- “To aid in the maintenance of appropriate body temperature during all anesthetics.”
- “Every patient receiving general anesthesia should have body temperature measured when clinically significant changes in body temperature are intended, anticipated or suspected.”
- World Health Organization (WHO) Guidelines for Safe Surgery states: “A means of measuring body temperature should be available and used at frequent intervals where clinically indicated (e.g. prolonged or complex anesthesia, children).”
- Malignant Hyperthermia Association of the United States (MHAUS): “MHAUS recommends that all patients undergoing general anesthetics that exceed 30 minutes in duration should have their temperature monitored using an electronic temperature probe. Skin liquid crystal temperature sensors are not recommended as they have been found to be unreliable indicators of changing temperature during human malignant hyperthermia (MH) events.”
- ASPAN’s Evidence-Based Clinical Practice Guideline for the Promotion of Perioperative Normothermia states: “Frequent intraoperative temperature monitoring should be considered in all cases”
To support your patient monitoring needs and enhance compliance with patient safety and anesthesia monitoring requirements, Starboard Medical LLC offers a full line of disposable electronic temperature probes. Visit www.starboardmedical.com to learn more.