Emergency
AMHA - Emergency

Emergency

Criteria Used in the Clinical Grading Scale for Malignant Hyperthermia  

From Larach et al [1994], Rosenberg et al [2015]

  • Questions
  • Manifestation
  • Clinical Finding (Maximum Score)
  • Choose
  • 1
  • Manifestation  End-tidal CO2 >55 mm Hg, PaCO2 >60 mm Hg
  • Clinical Finding Respiratory acidosis (15)
  • 2
  • Manifestation  Unexplained sinus tachycardia, ventricular tachycardia, or ventricular fibrillation
  • Clinical Finding Cardiac involvement (3)
  • 3
  • Manifestation  Base deficit >8 mEq/L, pH<7.25
  • Clinical Finding Metabolic acidosis (10)
  • 4
  • Manifestation  Generalized rigidity, severe masseter muscle rigidity
  • Clinical Finding Muscle rigidity (15)
  • 5
  • Manifestation  Serum creatine kinase concentration >20,000/L units, cola-colored urine, excess myoglobin in urine or serum, plasma [K+] >6 mEq/L
  • Clinical Finding Muscle breakdown (15)
  • 6
  • Manifestation  Rapidly increasing temperature, T >38.8° C
  • Clinical Finding Temperature increase (15)
  • 7
  • Manifestation  Rapid reversal of MH signs with dantrolene (score=5)
  • Clinical Finding Other
  • Manifestation  Elevated resting serum creatine kinase concentration (score=10)
  • Clinical Finding Other
  • 8
  • Manifestation  Consistent with autosomal dominant inheritance
  • Clinical Finding Family history (15)