What is required by accrediting groups?
The Joint Commission says that "emergency medications and other interventions can help mitigate the impact of a [malignant hyperthermia (MH)] episode, but only if the needed materials are readily available and staff is adequately trained." Specifically, The Joint Commission requires:
- Emergency medications and/or supplies, if any, are consistently available, controlled, and secured.
- The organization provides initial orientation.
- Staff and licensed independent practitioners, as appropriate, can describe or demonstrate their roles and responsibilities relative to safety.
- Staff competence to perform job responsibilities is assessed, demonstrated, and maintained.
- The organization responds to life-threatening emergencies according to organization policy and procedure.
- Operative or other procedures and/or the administration of moderate or deep sedation or anesthesia are planned.
The Accreditation Association for Ambulatory Health Care (AAAHC) says written protocols and emergency equipment and drugs for the treatment of MH are maintained and readily available, if the organization administers agents known to trigger malignant hyperthermia. (See list, below.) AAAHC also requires that malignant hyperthermia drills are performed at least yearly.
Potential Malignant
Hyperthermia Triggering Agents
Source: Malignant Hyperthermia Association of the United States, Sherburne, NY. |
The association says providers should stock a minimum of 36 vials of dantrolene sodium for injection, if they administer agents known to trigger MH. If potent volatile agents are not used, and succinylcholine is available for resuscitation, a minimum of 36 vials of dantrolene should be available.
The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) says the malignant hyperthermia algorithm from the Malignant Hyperthermia Association of the United States (MHAUS) must be available on the emergency cart if potential malignant hyperthermia triggering agents are ever used or are present in the facility. Additionally, the organization requires:
- at least 1,000 ml (intravenous bag or similar container) of preservative free H2O diluent for dantrolene;
- at least four 50 cc ampules of NaHCO3;
- at least 12 vials of dantrolene;
- an additional 24 vials of dantrolene and diluent stored in the facility, or a written agreement with another source that will provide 24 vials of dantrolene and diluent within 15 minutes.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content