Version May 2024
| Quantity per cart* | |
| Drugs | |
| Dantrolene: | |
| 36 vials (enough supply to prepare maximum recommended cumulative dose [ie, 10 mg/kg] for one 72 kg patient) |
| OR | OR |
| 3 vials (enough supply to prepare maximum recommended cumulative dose [ie, 10 mg/kg] for one 75 kg patient) |
| Sterile water for injection (non-bacteriostatic): | |
| 36 vials |
| OR | OR |
| 3 vials |
| Sodium bicarbonate 8.4% (also labeled 1 mEq/mL or 1 mmol/mL), 50 mL¶ | 5 prefilled syringes or vials |
| Dextrose 50%, 50 mL¶ | 2 prefilled syringes or vials |
| Calcium chloride 10%, 10 mL¶ | 2 vials |
| Lidocaine 2%, 100 mg/5 mL OR 1%, 100 mg/10 mL¶ | 4 prefilled syringes or vials |
| Refrigerated drugs and solutions | |
| Insulin regular 100 units/mL, 10 mL | 1 vial |
| 0.9% normal saline, 1000 mL for IV cooling | 4 bags and sterile pour bottles |
| Cold packs | 8 |
| General equipment | |
| Syringes, 60 mL to dilute dantrolene (unnecessary if using Ryanodex)¶ | 5 syringes |
| IV catheters (for IV access and arterial line): 16G, 18G, 20G 2-inch, 22G 1-inch, 24G ¾-inch¶ | 4 each |
| NG tubes¶ | Various sized |
| 60 cc irrigation syringe¶ | 2 |
| Monitoring equipment | |
| Esophageal or other core temperature probes (eg, for nasopharyngeal, tympanic membrane, rectal, or bladder sites, or a pulmonary artery catheter)¶ | |
| CVP kits (sizes appropriate to your patient population)¶ | Sizes appropriate for patient population |
| Transducer kits for arterial and central venous cannulation¶ | |
| Nursing supplies | |
| Large sterile plastic drape (eg, Steri-Drape, for rapid drape of wound)¶ | 1 |
| Urine meter¶ | 1 |
| Irrigation tray with piston (60 cc irrigation) syringe¶ | 1 |
| Small and large clear plastic bags for ice¶ | 4 each |
| Bucket for ice¶ | 1 |
| Test strips: urine analysis for hemoglobin and finger stick glucose¶ | 1 vial |
| Laboratory testing supplies | |
| Syringes (3 mL) for blood gas analysis or ABG kits × 6 or supplies for point-of-care testing device (eg, iSTAT). | |
| Blood specimen tubes for CK, myoglobin, CMP, thyroid studies, PT/PTT, fibrinogen, fibrin split products, lactate, and CBC. If no immediate laboratory analysis is available, samples should be kept on ice for later analysis. This may well prove useful on retrospective review and diagnosis. Blood cultures are very useful and should be included to rule out bacteremia. | |
| Urine collection container for myoglobin level. Pigmenturia (eg, brown or red urine and heme-positive dipstick) indicates that renal protection is mandated, when the urine is centrifuged or allowed to settle, and the sample shows clear supernatant, ie, the coloration is due to red cells in the sample. | |
MH: malignant hyperthermia; IV: intravenous; NG: nasogastric; G: gauge; CVP: central venous pressure; ABG: arterial blood gas; CK: creatine kinase; CMP: comprehensive metabolic panel; PT: prothrombin time; PTT: partial thromboplastin time; CBC: complete blood count.
* We suggest that institutions establish the number and location of MH treatment carts so that one or more carts is available immediately or within no more than 10 minutes to all anesthetizing locations in the facility including operating rooms and procedural suites.
¶ These supplies are only necessary if not already immediately accessible at all anesthetizing locations in the institution.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
