Malignant hyperthermia: considerations for ambulatory surgery

Patient care offered on an ambulatory basis continues to grow as evidenced by the high percentage of surgical procedures now being performed in such a setting. Many ambulatory surgical facilities are free standing and remote from the primary hospital location. As the popularity of ambulatory surgical care increases, so does the likelihood of encountering malignant hyperthermia-susceptible patients or of experiencing a malignant hyperthermia crisis. The management of this unique population creates new challenges for the perianesthetic nurse working in the free-standing ambulatory setting. A comprehensive plan of patient care under these circumstances includes (1) the ability to identify the high-risk patient and to plan their care accordingly, (2) early recognition of the signs and symptoms of malignant hyperthermia, and (3) being prepared to promptly and efficiently treat a malignant hyperthermic event. This review article will offer guidelines for managing the malignant hyperthermia-susceptible patient in the remote ambulatory surgical setting.