Ruling out the differential diagnoses of uncontrolled pain, sepsis, hypoglycemia, seizure disorder, thyroid storm, neuroleptic malignant syndrome, transfusion reaction, or medication withdrawal, we suspected a diagnosis of MH and called the MHAUS 24-hour MH Hotline.
Per MHAUS, RYR1 gene sequencing is currently available at only two accredited molecular genetics laboratories in the United States  and substantial efforts were required on our part in order to link the laboratory at our hospital with one of these testing centers.
MHAUS recommends that all facilities where MH triggering anesthetics and depolarizing muscle relaxants are administered should stock dantrolene .
 "MHAUS guidelines: testing for malignant hyperthermia (MH) susceptibility: how do I counsel my patients?" Malignant Hyperthermia Association of the United States, https://www.mhaus.org/testing/introduction-to-mh-testing/ testing-for-malignant-hyperthermia-mh-susceptibility-how-do-i-counsel-my- patients/; 2018 [accessed 4 April 2018].
In fact, administration of dantrolene as soon as possible is the most important measure recommended by the MHAUS
and EMHG.[sup], However, in countries such as China, importing and using dantrolene are not approved; thus, treatment on MH is a big challenge.
(The malignant hyperthermia hotline [800-644-9737] at MHAUS
is available 24 hours a day to assist clinicians with questions regarding diagnosis and treatment.)
According to Dianne Daugherty, Executive Director of MHAUS, what is so dangerous about MH is that unless a patient has knowledge of past family history of MH, he/she will not be aware of the potential risk, as MH-susceptible individuals do not display symptoms in normal day-to-day activities.
Again, according to the MHAUS Web site, incidence of MH ranges from 1 in 5,000 to 1 in 65,000 surgeries.
While there are a number of supplies MHAUS recommends an OR have on hand in case of an MH event, the key ingredient to saving a patient is dantrolene.
In addition to the adequate supplies to treat MH efficiently, MHAUS recommends the MH Emergency Therapy treatment poster be hung in the OR and the MH hotline number be at staff's fingertips.
Malignant Hyperthemia Association of United States (MHAUS