Early malignant hyperthermia during volatile anesthesia
Educational use only. Not clinically reviewed24-year-old man for Arthroscopic anterior cruciate ligament reconstruction. About 10 simulated minutes.
What you will practise
- Recognize the early hypermetabolic pattern.
- Stop volatile delivery and hyperventilate with 100% oxygen at high fresh-gas flow.
- Give 2.5 mg/kg intravenous dantrolene promptly and repeat while observable signs persist.
- Reassess carbon dioxide, heart rate, rigidity, and the later temperature trajectory after initial treatment.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Malignant Hyperthermia Association of the United States. Managing a Crisis. Current web protocol consulted 2026-08-23.
- Glahn KPE, et al. Recognition and management of a malignant hyperthermia crisis: updated 2024 guideline from the European Malignant Hyperthermia Group. Br J Anaesth 2025;134:221-3. PMID 39482150
- Hopkins PM, et al. Malignant hyperthermia 2020: Guideline from the Association of Anaesthetists. Anaesthesia 2021;76:655-64. PMID 33399225
- Larach MG, et al. Clinical presentation, treatment, and complications of malignant hyperthermia in North America from 1987 to 2006. Anesth Analg 2010;110:498-507. PMID 20081135
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.