Support and reply to the following discussion board post from classmate using two references no later than 10 years old:
Malignant hyperthermia (MH) is a critical emergency that can occur from common anesthesia medications used in surgery. MH is linked to a rare genetic musculoskeletal hypermetabolic disorder (Spruce, L., 2020). Currently the only way to definitively test for predisposition of developing MH is through genetic testing and muscle biopsy testing (Hommertzheim & Steinke, 2006). MH is very rare and therefore these tests are not easily assessable or frequently used to determine risk prior to surgery. The best way to evaluate risk for MH prior to surgery is through assessment of patient and family history, as the disorder is autosomal dominant. It is the perioperative nurses role to know the risk factors for MH as well as the triggers agents which include inhaled general anesthetics and succinylcholine (Spruce, L., 2020). If the patient is deemed a risk prior to surgery the triggering agents must be avoided, but all patients should be monitored throughout the operation for potential signs and symptoms. Despite the name malignant hyperthermia, elevated temperatures are a late sign, the early signs are elevated CO2 levels, rapid heart rate, rapid respiratory rate, muscle rigidity (Hommertzheim & Steinke, 2006). It is very important all surgical team members are vigilant of these early signs as they can be easily masked in the operative setting. Later signs include elevated temperature, EKG changes, and disseminated intravascular coagulation that can result in multisystem organ failure and death rigidity (Hommertzheim & Steinke, 2006). MH can occur at any time from the induction of the anesthetic agent up to 12 hours following the last administration. If MH is suspected it is critical that the anesthetic agent is stopped if it is still running, the patient is hyper-oxygenated, the emergency response is activated within the OR (or the PACU if the symptoms present late) and the reversal agent dantrolene is administered rapidly. The patient may experience rebound symptoms up to 24 hours after the onset of MH and therefore must remain under observation for 48-72 hours (Hommertzheim & Steinke, 2006). If a patient develops MH it is critical that following treatment and stabilization the patient and family is educated on the recurrent risk for any future procedure requiring general anesthesia.
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