MH in L&D: Recognize & Act

Medical/Nursing simulations which focus on high-acuity, low-frequency crisis events improve team dynamics, team morale, and most importantly patient outcomes. One such high-acuity, low-frequency event is malignant hyperthermia (MH). On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and most commonly used anesthetics. However, general anesthesia is performed when the case is emergent (stat), when the regional anesthesia level is insufficient, or regional anesthesia is contraindicated (low platelets). Joint Commission accreditation included preparedness for medical reactions/emergent conditions, including malignant hyperthermia. In this episode we will provide a high-yield summary of MH including etiology, pathophysiology, medication rescue, and supportive care for this potentially life threatening emergency.