Question:

I am a Surgical Services Line Educator heading to The Federated States of Micronesia the island of Pohnpei and I will be lecturing on Malignant Hyperthermia to their OR Staff on the island’s only hospital. My question is this; do you have any reported cases of MH from the South Pacific? How would I go about researching this? I am traveling with the Moran Eye Center International Outreach team, they are part of the University of Utah Health Care system.
  

Answer:

If you consider the Phillipines part of the South Pacific, then yes, there was a case. A call came from a Navy Hospital Ship, and it was MH in a young Filipino boy, and the patient was successfully treated. The case was actually reported in Military Medicine.

Answer:

In some ways it is different, for example: If hyperkalemia (K > 5.9 or less with ECG changes) is present, treat with bicarbonate, glucose/insulin and calcium: For pediatric patients: 0.1 units regular insulin/kg IV and 0.5 Grams/kg dextrose (% in formulation not important). For adult patients: 10 units regular insulin IV and 50 ml 50% glucose. For more information please click this link: http://www.mhaus.org/healthcare-professionals/managing-a-crisis

Answer:

According to the MHAUS website under “FAQs: General MH Questions: How is MH Treated?” cold isotonic saline for IV infusion and gastric, peritoneal or rectal irrigation is recommended.

If all you had at hand to emergently cool a patient was cold IV lactated ringers solution, it could certainly be used (at least until you could get some isotonic saline to give).

However, would not make a special effort to stock it in an MH cart. Keep things simple and have cold IV saline 0.9% available. Also, LR has a bit more potassium in it than saline and the possibility that a patient may receive a large volume of IV fluid during an MH event could exacerbate the hyperkalemia that often occurs during MH.

Answer:

If they need the time to flush the machine then scheduling MH surgery as the first case is helpful. If they have charcoal filters then probably not necessary.

Answer:

Ice to the axilla and groin along with cold lavage of stomach and surgical wound are given as recommendations for cooling with the caveat to stop cooling at 38 degrees.  Not aware that cooling blankets were accorded much importance.