Preparing the OT for MH risk

malignanthyperthermia mh patient safety perioperativenursing safety volatileagents Mar 04, 2024
Malignant Hyperthermia (MH) is a life threatening hereditary disorder that is triggered by volatile anaesthetic agents and suxamethonium. In susceptible patients (or those who might be susceptible), there are a few key steps we must take to prevent triggering MH! 👉🫡
 
Here’s how to prepare the operating theatre:
 
Remove triggers from OT
👉 Volatile anaesthetic cartridges
👉 Suxamethonium
 
Remove and replace
👉 Anaesthetic circuit (remember that spare lung should also be replaced!)
👉 Mask, CO2 line and HMEF
👉 Soda lime
👉 Ventilator bellows and tubing (for some models)
 
Flushing the anaesthetic machine is required to remove volatile anaesthetic agent contamination. Flushing times vary between types of machine, so we recommend you refer to the manufacturer guidelines for your machine!
 
After the required flushing time is completed, flushing should be continued until use for all machine types.
 
A note on activated charcoal filters (ACFs) for removal of residual volatile anaesthetic
👉 These are not mandatory, but if available should be used
👉 ACFs do not replace adequate flushing practices
👉 ACFs should be placed on both the inspiratory and expiratory limbs
 
Keep an eye out for our other Concept Series Articles and Live Series on Malignant Hyperthermia to keep your susceptible patients safe!
 
Build knowledge ✅
Improve safety ✅
 
Ref: https://www.bjanaesthesia.org/article/S0007-0912(20)30787-X/fulltext
  

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