Malignant Hyperthermia is scary!  When it hits you have very little time to save the patient and you also need to have the appropriate supplies.  First, you should always monitor your patients temperature during anesthesia procedures as a rapid rise in patient body temperature is a key indicator of a Malignant Hyperthermia episode. Additionally, you should always follow the ASA guidelines for proper patient monitoring during anesthesia.  It is also important that you have access to an Malignant Hyperthermia cart that is appropriately stocked should an episode arise. 

When it comes to what should be in an MH emergency cart, we look to the experts for advice.  MHAUS is the Malignant Hyperthermia Association of the United States, they suggest that the MH Emergency cart has the following items:

  1. Specific drugs targeted to treat an MH episode. These drugs are used in different doses to help treat MH, and it is important to always have them stocked inside an MH cart. The drugs that need to be available include:
    1. Dantrolene
    2. Sterile water for injection USP
    3. Sodium bicarbonate
    4. Dextrose
    5. Calcium chloride
    6. Regular insulin
    7. Lidocaine for injection
    8. Refridgeratred cold solution1
  2. General equipment including charcoal filters, syringes, intravenous catheters, pressure bag, disposable cold pack.1
  3. It is important to have Monitoring Equipment in order to detect any changes in core body temperature or any signs of MH. This equipment consists of esophageal or other core temperature probes, CVP kits, transducer kits.1 A great option in monitoring equipment is Starboard Medical’s temperature line, carefully crafted with patient care in mind. These devices can help detect a Malignant Hyperthermia episode early on. 
  4. Nursing Supplies such as large sterile Steri-Drape, urine meter, large clear plastic bags for ice, bucket for ice, test strips for urine hemoglobin.1
  5. Laboratory testing supplies including syringes, blood specimen tubes, urine collection containers.1

Malignant Hyperthermia carts help ensure you have access to properly care for your patient in the case of a Malignant Hyperthermia episode. In the case of a death from MH that is attributed to the lack of timely availability of drugs is not justifiable in the United States today.2 

Please visit the MHAUS website for more up to date information on Malignant Hyperthermia and detailed specifics of what should be in the MH Emergency cart. And remember, monitoring your patients body temperature during anesthesia procedures is a key patient parameter that can help guide on what measures to take to keep your patients safe.