In addition the video contained in the kit allowed the organizers to have an idea of how a well run drill would take place. Educate staff members on responsibilities. Upon hearing the alarm make a head count and instruct all occupants to the nearest exit. One of our nurse educators has been using the manikin simulator extensively in training nursing personnel throughout the hospital. Information regarding testing can be found at www. Hospitals must be prepared to respond to public health emergencies that may create a sudden demand on services. Team training is complex and requires planning, coordination and constant reevaluation.
Malignant hyperthermia is a biochemical chain reaction in the skeletal muscles in response to certain general anesthetic agents and succinylcholine, according to Ms. We prepared in advance the results of a blood gas analysis and electrolytes that would be drawn during the procedure. Treatment must be instituted rapidly on clinical suspicion of the onset of malignant hyperthermia. Working with our nurse who uses simulations regularly we worked out a rough timeline for the crisis. I recently had to under go a pretty intense hip surgery surgery. Disaster drills allow hospitals to test response capabilities to these emergencies in real time. To give the patient the best possible chance for a successful outcome, a swift, coordinated, multidisciplinary team response is necessary.
In pediatric patients, the first sign can be cardiac arrest. Testing is available at special centers. The discussion was again videotaped for replay for nurses on the off-shifts. We also have a very active nursing and medical education department and have had some experience with manikin simulation although no centralized simulation center. Finally after doing the announced drill several times, it will be time to do an unannounced drill.
You must activate a signal during all drills whether pulling the fire pull station or setting off a smoke alarm. For example, one person was tasked with getting ice to place on the patient. Consider the availability of petty cash so that a business office staff member could quickly purchase ice if needed. Ensure all waiting area occupants walk safely and keep to one side to evacuate the building and proceed to a safe refuge area. Burden notes that this is a dangerous practice. Upon complete evacuation of the building, the safety officer will inform you when you may return to the building.
New quick- mixing versions make reconstitution much easier and quicker. Had that not been possible, the event would have been videotaped for discussion at a later time. Carriers with susceptibility often are unaware they are at risk. Centers should also plan ahead for the fastest method of transporting dantrolene from another facility. Perioperative standards and recommended practices 2008 Ed.
Other facilities might be able to secure expired Dantrium from their pharmacy prior to return to the company. Burden suggests practicing dilution with expired vials of dantrolene. Anesthesia provider should speak with them on a cell phone. First a few words about my institution. Additionally, past After Action Reports and Improvement Plans provide previously identified areas for improvement that can be tested.
We are again fortunate to have excellent media support for this, but given the modern capabilities for audiovisual recording this could have been done by one of the staff or a volunteer, although the quality might not have been as high. Although it is expensive to have the proper supply on hand, it is a small amount for an insurance policy for patient safety. The main purpose of the video was for the debriefing session. New mandates dictate that the individual in charge of initiating the drill this person is deemed as the safety officer must also submit to the Quality Committee a written critique evaluating the fire drill along with the actual documentation of the fire drill. A script is included by the phone numbers so that any staff member can call. Guide to malignant hyperthemia in an anesthesia setting. Decision would be made by anesthesia provider to use prophylactic treatment.
I credit my super quick recovery to the blanket. Average of 30 vials used per crisis. The nurse educators then had to work with the volunteer staff to identify the roles they were to play. These problems were subsequently corrected. Plan for the ongoing care of the patient.
Because these events are rare, but devastating, it is essential for every center to be as prepared as possible. We therefore settled on an early morning drill. The results can be applied to training and drill planning. Anesthesia provider will make decision of timing of transfer. This eventually results in the textbook extreme rise in body temperature, although other symptoms precede that hyperthermic state. All of these decisions required three meetings and as well as discussions with our media person and the others on the team. On the day of the drill, our video team and simulator expert arrived very early to get everything in order.
But the center should also consider the potential for needing backup for ice. The whole process leading up to the surgery was traumatic for obvious reasons. Each of the participants identified themselves to each other and explained what they were going to do in the drill. It is the intent of the checklist to provide an overview, guidance and resources for hospitals which allows a more coordinated effort and can be tailored to the facility. It so happened that the next week a grand rounds program for both the anesthesia and surgery departments had been arranged, but at the last minute the speaker cancelled. Nancy Burden, director of ambulatory surgery for BayCare Health System in Largo, Fla. Avoidance of triggering agents is primary prophylactic approach.