Abstract
Malignant Hyperthermia (MH) is a genetically inherited, pharmacogenic disorder involving a severe malfunction within the skeletal muscles, causing them to be stuck in a contracted state. It is found to be triggered in susceptible patients by the administration of certain anesthetic agents during and after surgical procedures. It may also be activated by the use of other drugs, such as muscle relaxants and triggered by other circumstances such as stress, trauma, and even exercising. Not only are the muscles normal physiology affected, but abnormalities of the whole body occur disrupting its natural homeostasis. If it is not treated immediately, it can be fatal. Susceptibility is found in patients who have had a known family history of MH. In order for a medical professional or a patient to be prepared to handle MH one must understand how it affects the normal physiology of the body, what signs to look for, and how it can be diagnosed, treated, and prevented. There is no cure for MH, but there are specific drugs and precautionary measures that are used to prevent and treat it when a patient is susceptible.
A Brief Overview of Malignant Hyperthermia
Malignant Hyperthermia is a life-threatening, genetic disorder that involves the skeletal muscles. It commonly occurs intraoperatively and postoperatively when inhalant agents such as halothane, enflurane, and isoflurane are used, as well as some muscle relaxants such as succinylcholine and curare. It
Hypothyroidism can affect the body temperature because it slows down the metabolism. This causes the energy produced to be less. With that
The patient in “The Red Hat Hikers” scenario is suffering from hyponatremia. Hyponatremia is defined as a serum sodium level of less than 136mEq/L. Sodium is an electrolyte that is found predominately in the extracellular fluid, and it is the chief regulator of water in the body. Sodium is also important for muscle contraction, nerve impulses, acid-base balance and chemical reactions that occur inside the cell (McCance & Huether, 2014). Normal sodium levels in the body are maintained by the kidneys and the hormone aldosterone. Aldosterone is secreted by the adrenal cortex at the completion of the renin-angiotensin-aldosterone system, and it helps stimulate the proximal tubules of the kidneys to reabsorb sodium and water. The anti-diuretic hormone (ADH) also indirectly affects sodium levels because it regulates water balance in the body (McCance & Huether, 2014).
The scientific, medical explanation about hyperthermia is that thermal regulation centers around the brain help to maintain the internal body temperature by adjusting the amount of salts in perspiration. Electrolytes help the cells in body tissues maintain water balance. In hot weather, a healthy body will lose enough water to cool the body while creating the lowest level of electrolyte imbalance. If the body loses too much salt and fluid, symptoms of dehydration will occur. The healthy human body keeps a steady temperature of 37 degree Celsius, in hot weather, the body perspires. As perspiration evaporates from the skin, the body is cooled, then the thermal regulating system in the brain helps the body adapt to high temperature.
A (assessment): Ms. O’Reilly’s vital signs are temperature of 37.5 C, pulse of 112, blood pressure of 102/52, and respirations of 24. Her respirations are still deep but have a regular rhythm. She has a CBS of 8.1 and regular insulin running as per orders. The lab work shows uncompensated metabolic acidosis with no hypoxia. Ms. O’Reilly’s neurological status has improved with a GSC of 13. Her dehydration is being treated with NS containing 40mEQ KCL/L running at 200ml/hr and potassium levels maintained at 4.
Malignant Hyperthermia is primarily thought to be an autosomal dominant genetic disorder that causes a hypermetabolic state after administration of volatile anesthetics. When a patient is under anesthesia, the muscles are usually relaxed, but when a patient is experiencing Malignant Hyperthermia crisis, certain IV anesthesia causes the opposite effect. Most inhaled anesthetics other than nitrous oxide, cause or trigger Malignant Hyperthermia. More specifically, the anesthetic agents: Halothane, Chloroform, and Succinylcholine. The genic condition of Malignant Hyperthermia only becomes apparent when a patient is exposed to certain anesthetics such as halothane, which causes muscle rigidity.
SOCIAL HX: Any recent travel? If so, where to and for what duration of time? Causes (if recent travel to distant countries) may include Malaria, Viral Hepatitis, Diarrheal disorders, or Typhoid fever (Merck’s Manual, 2014). If recent travel around U.S., causes may include tick exposure (rickettsiosis, Lyme’s disease), mosquito exposure (arboviral encephalitis), wild animal exposure (rabies), fleas (plague), cat-scratch disease or toxoplasmosis, reptiles (salmonella), or bats (rabies) (Merck’s Manual, 2014). Any drug use? Drugs that can cause increased heat production include amphetamines, cocaine, ecstasy, and anesthetics (Merck’s Manuals, 2014).
Cancer is a disease in which cells multiply out of control and gradually build a mass of tissue called a tumor. There has been a large amount of research dedicated to the treatment and cure of cancer. Several types of treatments have been developed. The following are just some of the major examples of cancer therapy: surgery, chemotherapy, radiation therapy, biologic therapy, biorhythms, unconventional treatments, and hyperthermia. Each type of treatment is discussed in detail below.
Charging to 200....Stand clear…Shocking! CPR....EMS providers experience the adrenaline and rush of a patient in cardiac arrest. Trying to bring dead back to life is not a simple task by far, especially with the limitations and resources of the field. But, what happens after the patient makes it to definitive care? Annually, around 300,000 adults in the United States experience out-of-hospital cardiac arrests (AHA), and EMS providers only see the results of the short term survival of the patient, but rarely the actual patient care and recovery after an arrest. Patients undergo intense, aggressive treatment and recovery measures in the hospital post-code. These patients have a variety of treatment regimens
Hypothermia is a common problem in surgical patients. Up to 70% of patients experience some degree of hypothermia that is undergoing anesthetic surgery. Complications include but are not limited to wound infections, myocardial ischemia, and greater oxygen demands. The formal definition of hypothermia is when the patient’s core body temperature drops below 36 degrees Celsius or 98.6 degrees Fahrenheit. Thus, the purpose of the paper is to synthesize what studies reveal about the current state of knowledge on the effects of pre-operative warming of patient’s postoperative temperatures. I will discuss consistencies and contradictions in the literature, and offer possible explanations for the inconsistencies.
Hypovolemic shock is an urgent condition of rapid reduction of circulatory volume in the body, which can be created due to blood or plasma or body fluids loss (Kettley & Marsh, 2016, p. 31; Perner & Backer, 2014, p. 613). Blood loss can be induced by internal or external injuries, excessive perspiration or diuretics (Craft & et al, 2015, p. 852). Maureen Hardy’s hypovolemia has been precipitated by hematemesis.
55). According to Wen-Chih et al. (2010, p.11), ageing patients are susceptible to blood loss since they have limited physiological replacement. Thus, considering the age and the surgical procedure the patient is at high risk of hypovolemia. If the loss of blood progresses and the body is unable to compensate, the patient will be at risk for hypovolemic shock (D’Angelo, M., Dutton, R., 2009, p. 279). Hypovolemic shock means deficit in flowing blood causing to ineffectively filing the intravascular space. Mamaril, M., Child, S., & Sortman, S., 2007, p. 191. Kolecki, P., & Menckhoff, C. (2014) emphasizes that there are four (4) classification of hypovolemic shock. Class 1 is when there is 0-15% of blood loss with only slight change in heart rate. If the patient heart rate becomes more than 100 beats per minute and they experience tachypnoea and has cool clammy skin, the patient is in the class 2 of hypovolemic shock. Class 3 and 4 is when the patient will manifest the severe sympathetic response of the body due to the inability of compensate with the blood loss. Thus, considering the age and the surgical procedure the patient is at high risk of hypovolemia or even the more severe
Hypothermia is reduced body temperature that happens when a body dissipates more heat than it absorbs. In humans, it is defined as a body core temperature below .
Hypothermia is the unintentional lowering of a core body temperature below 36oC. During anesthesia a patent’s temperature will typically drop by 1-2o C in the first hour after inductions and will continue to decline into the third and fourth hour (Butterworth, Mackey, & Wasnick, 2013). This is attributed to the inhibition of central thermoregulation from the hypothalamus which regulates the body temperature by causing vasoconstriction and shivering (Butterworth, Mackey, & Wasnick, 2013). As a result of inhibiting vasoconstriction heat is redistributed from the central core to the periphery (Akhtar et al., 2016). Other factors that play a role in intraoperative hypothermia is the lower ambient temperature of the operating room, the infusion of cool fluids, and patient exposure to environment.
Shivering is a common problem during spinal anesthesia. It is the hypothermia that actually lowers the threshold for shivering which induces tachycardia, hypertension, and increase oxygen consumption by 400–500%. [1] In spinal anesthesia, there is peripheral redistribution of heat, loss of vasoconstriction below the level of the block with increase of heat loss from body surfaces, and altered thermoregulation with decrease in shivering thresholds. [2]
People who are outdoors get these disorders. The elderly, infants, and children without heat, clothing, or food are at a higher risk of getting hypothermia. The mentally ill are also at a great risk. Young children with seizure have a high chance of suffering from hyperthermia.