Malignant Hyperthermia

🔑 Key Priorities

  • Discontinue triggering agents

  • Administer dantrolene

  • Support circulation and treat hyperkalaemia, acidosis

🧠 Team Actions

Role

Task

Team Leader

Stop volatiles, call MH protocol, coordinate resus

Airway Manager

Switch to 100% O₂, high flows

Drug Assistant

Prepare dantrolene, cold saline, bicarb, insulin

Runner

Retrieve MH kit and call ICU

🧭 Management Algorithm

  1. Cease volatile agents and suxamethonium

  2. Give 100% O₂ at high flows

  3. Dantrolene 2.5 mg/kg IV immediately, repeat every 10 min if ongoing

    • Max 10 mg/kg

  4. Actively cool (ice packs, lavage, cold fluids)

  5. Treat hyperkalaemia and acidosis (see above)

  6. Maintain high urine output

  7. Send CK, myoglobin, K⁺, ABG, lactate

  8. ICU admission + Dantrolene maintenance infusion

🔄 Ideal Crisis Flow

           Malignant Hyperthermia
                   ↓
       Stop Volatiles + Sux + Call Help
                   ↓
       High Flow O₂ + Dantrolene IV Bolus
                   ↓
      Cool Patient + Treat Acidosis + K⁺
                   ↓
           ICU + Ongoing Dantrolene

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