Malignant Hyperthermia: The Dantrolene Sprint
Seconds matter in an MH crisis. Learn the sequence and the 'clean machine' logic.
MH: The Hypermetabolic Firestorm
We all talk about it, but few have seen it. A sudden rise in ETCO2, muscle rigidity, and hyperthermia. What actually ends up happening during the anesthesiology oral boards is that candidates forget the simplest first step: Stop the Trigger.
The Cliff: The "Filter" Mistake
Many candidates say "I will change the machine." The reality is, if you try to move a whole anesthesia machine during a code, you are wasting time. "I will immediately discontinue all volatile agents and succinylcholine, switch to 100% O2 at 10L/min, and place charcoal filters on the inspiratory and expiratory limbs of the circuit."
The Pivot: Dantrolene Dosing
You must know the dose by heart. "I will bolus 2.5 mg/kg of Dantrolene (or Ryanodex) and repeat as necessary until the symptoms abate. I will simultaneously begin cooling the patient and treating hyperkalemia."
Conclusion: Leading the Crisis
The boards want to see you delegate tasks: one person for Dantrolene, one for the MH hotline, one for cooling. Practice this "Crisis Resource Management" in the Oral Boards Bot.