Anaes Vivas · Malignant hyperthermia
Clinical viva — the malignant hyperthermia crisis protocol
A clinical viva walking through the MH crisis protocol — the declaration, the order of the bundle (stop triggers, hyperventilate, dantrolene, cool, treat hyperkalaemia, monitor, ICU), the dosing of dantrolene, and the pitfalls (delay, the calcium-channel-blocker interaction, recrudescence). The examiner wants a fixed, rehearsed sequence.
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Prompt
A young adult anaesthetised with sevoflurane develops a rapidly rising end-tidal carbon dioxide, tachycardia and a rising temperature. The examiner asks you to talk through your management step by step.
Stimulus
A young adult under sevoflurane anaesthesia, with an end-tidal carbon dioxide climbing out of proportion to ventilation, a tachycardia, and a rising core temperature. Talk through your management.
References3ShowHide
- [8]Glahn KPE, Girard T, Hellblom A, et al. Recognition and management of a malignant hyperthermia crisis: updated 2024 guideline from the European Malignant Hyperthermia Group. British Journal of Anaesthesia, 2025.PMID 39482150
- [7]Litman RS, Smith VI, Larach MG, et al. Consensus Statement of the MHAUS on Unresolved Clinical Questions Concerning the Management of Patients With Malignant Hyperthermia. Anesthesia & Analgesia, 2019.PMID 30768455
- [9]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.