CNOR D6 Emergency Identification and Management

Question 1

What is malignant hyperthermia (MH)?

Answer 1

A biochemical chain reaction response triggered by commonly used general anesthetics and succinylcholine.

Question 2

What are early signs and symptoms of malignant hyperthermia?

Answer 2

• Jaw tightening
• Increased CO2
• Hypermetabolic state
• Muscle rigidity
• Increased heart rate
• Increased blood pressure
• Metabolic acidosis

Question 3

What is the initial treatment for malignant hyperthermia?

Answer 3

Hyperventilate 100% O2 @ 10L/minute

Question 4

What are the unsafe anesthetic triggers for malignant hyperthermia?

Answer 4

• Desflurane
• Enflurane
• Ether
• Halothane
• Isoflurane
• Methoxyflurane
• Sevoflurane
• Succinylcholine

Question 5

What is the initial dose of Dantrium for treating malignant hyperthermia?

Answer 5

2.5 mg/kg

Question 6

What is anaphylaxis?

Answer 6

An acute allergic reaction causing the release of histamine into the bloodstream.

Question 7

What are immediate reactions of anaphylaxis?

Answer 7

• Edema
• Wheezing
• Cyanosis
• Difficulty breathing

Question 8

What should be done within 3 minutes of anaphylaxis onset?

Answer 8

Identify the item causing the anaphylactic response, if known.

Question 9

What are the signs and symptoms of hemorrhage?

Answer 9

• Hypotension
• Pale/cyanotic
• Moist skin
• Oliguria
• Tachycardia
• Restlessness
• Thirst

Question 10

What surgical items should be included in the estimated blood loss (EBL)?

Answer 10

Drapes, floor, suction canister, sponges visible, and weighing sponges.

Question 11

What is the visual estimation of blood loss for Raytec sponges?

Answer 11

3-12 ml

Question 12

What is the role of anesthesia during an emergency situation?

Answer 12

Manage patient airway and provide direction on shutting off medical gases.

Question 13

What is the recommended action for a nurse identifying a bag of PRBCs if anesthesia is busy during a transfusion?

Answer 13

Check the blood with another licensed individual.

Question 14

What should be monitored in a patient experiencing malignant hyperthermia?

Answer 14

• Blood gases
• Core temperature
• Urine output

Question 15

Fill in the blank:

The initial dose of Ryanodex for treating malignant hyperthermia is ______ mg/kg.

Answer 15

2.5

Question 16

What temperature is the intended outcome when cooling a patient during treatment of malignant hyperthermia?

Answer 16

To reduce core temperature to < 38 degrees Celsius.

Question 17

What environmental hazards should healthcare teams be prepared for?

Answer 17

• Natural disasters
• Terrorism
• Fire

Question 18

Define blunt force trauma as a mechanism of injury (MOI)?

Answer 18

Injury resulting from a combination of forces, such as acceleration, deceleration, shearing, and compression that do not result in a break of the skin.

Alexander’s Care of the Patient in Surgery