What are the signs of MH?
Hypercapnoea/tachypnoea, tachycardia, hyperthermia, acidosis, muscle rigidity (masseter spasm), compartment syndrome, rhabdomyolysis, AKI, coagulopathy
What is the management of MH?
Stop volatile and remove vaporiser
Hyperventilate with 100% oxygen at high flow
Declare emergency and call for help
Add charcoal filters and replace soda lime
Give dantrolene 2.5mg/kg Q10mins until temp <38.5 and CO2 <45mmHg
Treat hyperthermia(surface cooling and 2-3L cold crystalloid), hyperkalaemia, acidosis, AKI and coagulopathy
What are the differentials for MH?
Mechanical - low FGF, insufficient minute ventilation, machine problems
Patient - thyroid storm, sepsis
Anaesthetic - inadequate analgesia, anaesthesia, transfusion reaction
Idiosyncratic - neuroleptic malignant syndrome, serotonin syndrome, anaphylaxis
