Clinical Pathway Malignant Hyperthermia
Clinical Pathway: Malignant Hyperthermia
Courtney Daniel
RODP Program
Austin Peay State University
Clinical Pathway: Malignant Hyperthermia I. Introduction Case Study Mr. F, a healthy 34-year-old man, is admitted to a local hospital for a routine cholecystectomy. A preoperative assessment by the nurse anesthetist reveals no complications with prior surgeries and a familial history of anesthetic complications, but Mr. F is unsure of what the complications were called. During surgery, no adverse effects are noted by the surgical team. After successful removal of the gallbladder and an unremarkable anesthetic reversal, Mr. F is transported to the post anesthesia care unit (PACU) and monitored before being transferred to medical-surgical unit. Vital signs are as follows: heart rate, 75/min; blood pressure, 127/82 mm Hg; respiratory rate, 16/min; oxygen saturation, 100% on 2L of O² via nasal cannula; body temperature, 36.9°C. When Mr. F arrives to the PACU, the receiving nurse notices an increase in his heart rate to 91/min and an increase in respirations to 21/min. After administering a 3-mg IV bolus of morphine sulfate for pain and increasing oxygen delivery to 4L/min via nasal cannula, the nurse continues to see a gradual increase in heart rate and respirations as well as an increase in blood pressure and body temperature. Ten minutes later, Mr. F’s vital signs are now as follows: heart rate, 114/min; blood pressure 147/92 mm Hg; respirations, 25/min; oxygen saturation, 98% on 4L of oxygen via nasal cannula; and body temperature, 38.8°C. The nurse again treats with a 3-mg IV bolus of morphine sulfate and increases his oxygen to 5L by mask. During the nurse’s assessment, she notices Mr. F’s body temperature is increasing. As the surgeon and the certified registered nurse anesthetist are called to report Mr. F’s condition, the patient begins to experience muscle rigidity of the trunk. At this point, vital signs are as follows:
Courtney Daniel
RODP Program
Austin Peay State University
Clinical Pathway: Malignant Hyperthermia I. Introduction Case Study Mr. F, a healthy 34-year-old man, is admitted to a local hospital for a routine cholecystectomy. A preoperative assessment by the nurse anesthetist reveals no complications with prior surgeries and a familial history of anesthetic complications, but Mr. F is unsure of what the complications were called. During surgery, no adverse effects are noted by the surgical team. After successful removal of the gallbladder and an unremarkable anesthetic reversal, Mr. F is transported to the post anesthesia care unit (PACU) and monitored before being transferred to medical-surgical unit. Vital signs are as follows: heart rate, 75/min; blood pressure, 127/82 mm Hg; respiratory rate, 16/min; oxygen saturation, 100% on 2L of O² via nasal cannula; body temperature, 36.9°C. When Mr. F arrives to the PACU, the receiving nurse notices an increase in his heart rate to 91/min and an increase in respirations to 21/min. After administering a 3-mg IV bolus of morphine sulfate for pain and increasing oxygen delivery to 4L/min via nasal cannula, the nurse continues to see a gradual increase in heart rate and respirations as well as an increase in blood pressure and body temperature. Ten minutes later, Mr. F’s vital signs are now as follows: heart rate, 114/min; blood pressure 147/92 mm Hg; respirations, 25/min; oxygen saturation, 98% on 4L of oxygen via nasal cannula; and body temperature, 38.8°C. The nurse again treats with a 3-mg IV bolus of morphine sulfate and increases his oxygen to 5L by mask. During the nurse’s assessment, she notices Mr. F’s body temperature is increasing. As the surgeon and the certified registered nurse anesthetist are called to report Mr. F’s condition, the patient begins to experience muscle rigidity of the trunk. At this point, vital signs are as follows:
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