Certified Nurses Operating Room (CNOR) Practice Exam

What is the first action to take during a Malignant Hyperthermia crisis?

1. Administer anesthetic agents

2. Discontinue triggering agents

3. Initiate intravenous fluids

4. Begin CPR

The correct answer is: Discontinue triggering agents

In a Malignant Hyperthermia crisis, the most critical initial step is to discontinue any anesthetic agents that may have triggered the reaction. Malignant hyperthermia is a severe reaction to certain anesthetic medications, often presenting with rapid muscle metabolism, increased carbon dioxide production, and elevated body temperature. The presence of triggering agents exacerbates these symptoms, leading to a rapid decline in patient condition. By stopping the administration of these agents, the goal is to halt the progression of the crisis. This action is fundamental because it directly addresses the underlying cause of the hypermetabolic state. After discontinuing the triggering agents, the healthcare team can initiate further supportive measures, such as administering dantrolene, cooling measures, and intravenous fluids, which are critical to managing the symptoms of malignant hyperthermia. Thus, prioritizing the cessation of any triggering agents ensures that the immediate risks associated with the crisis are mitigated, establishing a foundation for further interventions to stabilize the patient.