FRANKFORT REGIONAL MEDICAL CENTER
Malignant Hyperthermia
Start
Intro
You are caring for a 33 year old male patient who is here for an elective hernia repair. He tells the preop nurse that he does not have any history of MH, but later mentions that an uncle and a cousin had died mysteriously during surgery years ago. The surgery starts uneventfully, but the CRNA alerts the team that the ETCO2 is increasing and the patient is becoming tachycardic. It is up to you and your team to collect the clues to save the patient. Instructions: Answer the questions to complete the escape room...
Continue
Clinical Signs
Unexplained tachycardia Sudden increase in ETCO2 Unexplained tachypnea Generalized muscle rigidity or masseter muscle rigidity Altered renal function Unexplained increase in O2 demand LATE SIGNS: Fever Rabdomyolysis Mottled skin Myoglobinuria
Continue
Mission 1
Locked
Locked
Locked
What do you do now???
- Call for help and get MH carts
- Stop triggering agent (anesthesia gases, succinylcholine)
- Hyperventilaye patient with 100% oxygen
- Start mixing Dantrolene
- Provide treatment to correct metabolic acidosis, hyperthermia, dysrhythmias, hyperkalemia, and other clinical symptoms
- Cool patient if core temperature greater than 102.2
- Monitor HR, RR, Core Temperature, ETCO2, O2 saturation continuously
Continue
What is the earliest clinical signs of MH?
Increasing ETCO2 & Unexplained tachycardia
Myoglobinuria (dark urine)
Fever
Mission 2
Locked
Completed
Locked
If MH is suspected, what is your first action?
Mix Dantrolene
Cool patient
Get Help! Call for MH Carts
Mission 3
Completed
Completed
Locked
Where are the MH Carts located at FRMC?
Cafeteria and Employee Parking Lot
Anesthesia supply room and outside the OB c-section room on second floor.
PACU and Preop
How many Dantrolene vials does FRMC have available?
25 in OR & 25 in OB = 50
20 in OR & 20 in OB = 40
18 in OR & 18 in OB = 36
What agency should be called if there is an MH crisis?
National Institutes of Health
Men In Black
MHAUS Hotline
Remember the code
216
Continue
Completed
Completed
Completed
Mission 4
What is the correct dosing and goal for Dantrolene administration?
5mg/kg (10ml vial mixed with 10ml normal saline within 5 minutes of symtom onset.
2.5mg/kg (20ml vial mixed with 60ml sterile preservative free water) within 10 minutes of symptoms.
100mg rapid IV push immediately
14+3
Continue
You have reached the last mission 🎉 Do you know what the code is?
Enter the password
Congratulations, you made it out!
Wrong answer!
Try again
Malignant Hyperthermia
MELANIE
Created on October 7, 2025
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Transcript
FRANKFORT REGIONAL MEDICAL CENTER
Malignant Hyperthermia
Start
Intro
You are caring for a 33 year old male patient who is here for an elective hernia repair. He tells the preop nurse that he does not have any history of MH, but later mentions that an uncle and a cousin had died mysteriously during surgery years ago. The surgery starts uneventfully, but the CRNA alerts the team that the ETCO2 is increasing and the patient is becoming tachycardic. It is up to you and your team to collect the clues to save the patient. Instructions: Answer the questions to complete the escape room...
Continue
Clinical Signs
Unexplained tachycardia Sudden increase in ETCO2 Unexplained tachypnea Generalized muscle rigidity or masseter muscle rigidity Altered renal function Unexplained increase in O2 demand LATE SIGNS: Fever Rabdomyolysis Mottled skin Myoglobinuria
Continue
Mission 1
Locked
Locked
Locked
What do you do now???
Continue
What is the earliest clinical signs of MH?
Increasing ETCO2 & Unexplained tachycardia
Myoglobinuria (dark urine)
Fever
Mission 2
Locked
Completed
Locked
If MH is suspected, what is your first action?
Mix Dantrolene
Cool patient
Get Help! Call for MH Carts
Mission 3
Completed
Completed
Locked
Where are the MH Carts located at FRMC?
Cafeteria and Employee Parking Lot
Anesthesia supply room and outside the OB c-section room on second floor.
PACU and Preop
How many Dantrolene vials does FRMC have available?
25 in OR & 25 in OB = 50
20 in OR & 20 in OB = 40
18 in OR & 18 in OB = 36
What agency should be called if there is an MH crisis?
National Institutes of Health
Men In Black
MHAUS Hotline
Remember the code
216
Continue
Completed
Completed
Completed
Mission 4
What is the correct dosing and goal for Dantrolene administration?
5mg/kg (10ml vial mixed with 10ml normal saline within 5 minutes of symtom onset.
2.5mg/kg (20ml vial mixed with 60ml sterile preservative free water) within 10 minutes of symptoms.
100mg rapid IV push immediately
14+3
Continue
You have reached the last mission 🎉 Do you know what the code is?
Enter the password
Congratulations, you made it out!
Wrong answer!
Try again