Answer:

No data exists on the effectiveness of any of the dantrolene products when administered via the intraosseous route. However, in the event that the patient is experiencing an acute MH event, and intravenous access can not be secured, it would be prudent to administer the dantrolene intraosseous in an attempt to get it into the patient to treat the MH episode.

Question:

Dantrolene is hard to mix. We are currently using bags of bacteriostatic free sterile water to mix our dantrolene. It is difficult for us to spike the bag each time and draw it with our 18 gauge needles. What is the best syringe/device available to obtain the water from the bag to rapidly draw it out with a syringe to mix it with the dantrolene?

Answer:

You should use glass vials and not bags because of the possibility of accidentally giving intravenously. There are various spring-loaded syringes that may help with this process. The new dantrolene preparation Ryanodex requires only 5 mL per 250 mg vial.