Medical Surgical Nursing

Malignant Hyperthermia 🌡

BACKGROUND  

The first thing you should notice in the phrase “Malignant Hyperthermia” is the word HYPERTHERMIA (elevated temperature)! So, what are we obviously going to see in this condition? A patient with a fever! 🌡

When patients go under general anesthesia, most of them go under fine, with no problems. However, patients with this condition (Malignant Hyperthermia), have problems with the usual medications that are used for general anesthesia. 💊

So, what happens in these patients? Their bodies’ response to the general anesthesia is that their muscles release too much CALCIUM once the medication is administered! When too much calcium is released, the muscles become super rigid! They maintain a fixed, contracted position.

BUT, you might be wondering, WHY does this happen to only a certain population of patient?

  • 👶🏽 Genetics! – If a patient has a relative who is known to have had malignant hyperthermia under general anesthesia, then they are likely to have the same problem! If the patient says their father had a “weird reaction” or “got a fever” or even “died” under general anesthesia, this is a big red flag that you should report to the provider! This is why we always ask patients if them or a family member has ever had any weird reactions under general anesthesia, to prevent MH for occurring in the first place!

SIGNS AND SYMPTOMS

  1. Hypercapnia (too much carbon dioxide [CO2]): this is an early sign; CO2 is being retained
  2. Muscle contractility and rigidity anywhere in the body*** [Most severe symptom!]
  3. 🌡🔝 A sudden rise in temperature: this is a huge tale-tell sign! Look out for a temperature that spikes all of a sudden, which can go even up to 105 degree Fahrenheit! (this is a later sign that can confirm the diagnosis of MH)

NURSING INTERVENTIONS & TREATMENTS

  1. 🚨 The very first thing you should do is Notify the Healthcare Provider to receive an order
  2. The Healthcare Provider will most likely order:
    1. Dantrolene (this is a muscle relaxant)** [Most important order to pay attention to!] 💊🚨
      1. ✖️ Works by inhibiting release of calcium from muscles
      2. ⬇️ Reduces muscle contraction
  3. 💧 Fluids will most likely also be ordered
  4. ⬇️🌡 Provide patient with cooling blanket to bring down the temperature

CLICK HERE to view my YouTube video on Malignant Hyperthermia!

Any questions?! Leave a comment below! ⬇️

Leave a Reply