Dantrolene reconstitution: description of a simulation model in malignant hyperthermia
Malignant hyperthermia is a potentially lethal condition triggered by succinylcholine exposure or exposure to halogenated anesthetic agents. Early identification of the crisis, as well as the timely administration of the specific treatment, impact the patient's outcomes. Any potential difficulties for dandrolene reconstitution are critical and may cause delays or preventable errors, if the operator is not familiar with the preparation and administration of the drug. The development of a simulation model to learn the process offers the possibility to acquire one of the skills required when facing a crisis of malignant hyperthermia. The high cost of the vials and sometimes the difficult access to the medication due to lack of availability in many institutions makes the option of simulating dantrolene reconstitution attractive, in order to familiarize the surgical team with the management of the drug. In this scenario, we submit a simulation model to learn the process of preparation of dandrolene in a controlled environment.
2. Bandschapp O, Girard T. Malignant hyperthermia. Swiss Med Wkly 2012; 142:w13652.
3. Neira VM. Hipertermia maligna en Bogotá. Rev Colomb Anestesiol 1993; 21:385-396.
4. Kollmann-Camaiora A, Alsina E, Domínguez A, et al. Clinical assistance protocol for the management of malignant hyperthermia. Rev Esp Anestesiol Reanim 2017; 64:32-40.
5. Dávila-Cervantes A. Simulation in medical education. Investig Educ Méd 2014; 3:100-105.
6. Issenberg SB, McGaghie WC, Petrusa ER, et al. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005; 27:10-28.
7. McGaghie WC, Issenberg SB, Cohen ER, Barsuk JHWD. Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 2011; 86:706-711.
8. Chopra V, Gesink BJ, de Jong J, et al. Does training on an anaesthesia simulator lead to improvement in performance? Br J Anaesth 1994; 73:293-297.
9. Larach MG, Gronert GA, Allen GC, et al. Clinical presentation, treatment, and complications of malignant hyperthermia in North America from 1987 to 2006. Anesth Analg 2010; 110:498507.
10. Krause T, Gerbershagen MU, Fiege M, et al. Dantrolene: a review of its pharmacology, therapeutic use and new developments. Anaesthesia 2004; 59:364-373.
11. Cain CL, Riess ML, Gettrust L, Novalija J. Malignant hyperthermia crisis: optimizing patient outcomes through simulation and interdisciplinary collaboration. AORN J 2014; 99:300-311.
12. Mitchell LW, Leighton BL. Warmed diluent speeds dantrolene reconstitution. Can J Anaesth 2003; 50:127-130.
13. Kugler Y, Russell WJ. Speeding dantrolene preparation for treating malignant hyperthermia. Anaesth Intensive Care 2011; 39:84-88.
14. Rosenberg H, Pollock N, Schiemann A, et al. Malignant hyperther-mia: a review. Orphanet J Rare Dis 2015; 4:90.
15. Khan TH. Malignant hyperthermia, dantrolene and apathy. Anaesth Pain Intensive Care 2016; 20:129-130.
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