The exact incidence of malignant hyperthermia (MH) is unknown. Estimates are that it ranges between 1 in 5,000 surgeries to 1 in 150,000 surgeries.
The prevalence of the genetic abnormalities that predispose individuals to MH is much higher, with estimates of 1 in 2,000 individuals to 1 in 4,000 individuals. By having regularly scheduled MH drills at your surgical facility, your team will be prepared if this condition occurs. The intent of conducting regularly scheduled MH drills is for all clinical staff to be familiar with the management of MH, the administration of Dantrolene/Ryanodex, and what their assigned roles are during the event, all of which are key to successful patient outcomes. Annual drills are required when triggering agents are available in the facility. However, annual drills are not required if a triggering agent is on-site for emergency use only.
Upon survey, compliance will be measured by the following:
- The surveyor will review the facility protocol for MH drills.
- The surveyor will interview clinical staff regarding their role in an MH crisis and management. Can staff recite their role?
- The surveyor will ask for evidence that MH drills are conducted annually, including documentation of staff who participated in the drill.
- The surveyor will look for evidence that the actual dilution of at least one (1) vial of (expired) Dantrolene occurred during the drill.
- The surveyor will review personnel files, including contracted healthcare professionals, to determine if the annual training requirement has been met
To further support facility staff and promote the best patient outcome possible, some facilities find it helpful to create assignment cards for each team member that include information such as identifying a simulated MH crisis, stopping triggering anesthetic agents, hyperventilating the patient with 100% oxygen, continually monitoring the patient, calling 911, calling the mhaus.org hotline, obtaining the emergency cart, beginning the process of diluting Dantrolene, securing other medications, obtaining ice to cool the patient, recording the medications administered and preparing patient demographics for transport, etc.
Anesthesia professionals are an excellent source of information for your drill and often welcome the opportunity to guide the team. In addition, mhaus.org has a variety of resources available for cost such as videos, posters, and testimonials of patients who have experienced and survived an MH crisis. The purpose of an MH drill is to ensure that your team will act cohesively and confidently. Together we can improve patient safety!
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
