Malignant Hyperthermia Crisis: Optimizing Patient Outcomes Through Simulation and Interdisciplinary Collaboration

Abstract

Background Malignant Hyperthermia (MH) is a rare, life-threatening event and many clinicians may be unprepared for management should a crisis occur. Simulation is a recognized teaching method to facilitate learning in a safe environment, and scenarios can be developed to resemble real life experiences. Our aim was to provide education to operating room (OR) staff in its early recognition, treatment, and management. Methods We formed an interdisciplinary perioperative team and developed an MH education plan for OR staff. An educational presentation by an anesthesiologist was followed by role playing scenarios using high-fidelity simulation in the OR suite. Results and Clinical Implications OR staff responded very favorably to the lecture and the simulation exercise. Outcomes achieved included role clarity, improved anticipatory response and overall team cohesion and interaction. As an immediate consequence, the MH cart was updated and reorganized and an institutional MH policy implemented.

Educational intervention on malignant hyperthermia with nursing professionals of the operating room

“…Similar results were found in some studies that evaluated the effectiveness of educational programs (9,(13)(14) . In general, malignant hyperthermia is little addressed in professional training courses.…”

“…An American study with undergraduate nursing students has evidenced the lack of information on treatment and management of malignant hyperthermia, resulting in the creation of an educational strategy for this group (9) . In Brazil, there are no studies focusing on educational strategies with this theme.…”

“…If the individual has no availability and even if the material is potentially significant, the subject may choose to simply memorize it (8) . The use of treatment simulations is a teaching method designed to facilitate a safe environment for learning exercises, by providing a path between formal education and professional practice, especially effective for rare but potentially fatal situations, such as malignant hyperthermia (9) . Professional training also allows the creation of a coordinated multidisciplinary team, such as a Rapid Response Team (RRT) (10) , allowing the best chance of success for patient recovery in a crisis.…”

Knowledge of nursing professionals of a surgical center regarding malignant hyperthermia

“…(9) In a study on the knowledge of Brazilian anesthesiologists faced with MH with 10 respondents, the researchers found 80% of correct answers on the diagnosis and 70% on the treatment. On the other hand, only 20% of these respondents knew the side eff ects of dantrolene and 40% of the responses on the pharmacology of dantrolene were incorrect.…”

“…(7,9,13,14) Professional training is directly linked to giving the patient the best chance of success in recovering from the crisis by means of a coordinated multidisciplinary team such as a rapid response team (RRT). (7) The creation of rapid response teams within healthcare institutions has increased in parallel with the increased interest in improving the quality of care.…”