Adapted from the booklet - "The Prepared Patient" from the Malegnant Hyperthermia Association of the United States (1.800.98.MHAUS).

If you are scheduled to undergo surgery at Jefferson you may be asked to come to the hospital a few days before the operation for preadmission testing. You may have laboratory tests done, talk to an anesthesiologist, and will be asked to fill out a pre-anesthesia questionnaire.

A pre-anesthesia questionnaire is a set of questions that gives your anesthesia provider important information about your health history and your family health history including previous experiences with anesthesia. Your anesthesia provider will incorporate this information with the results of any preliminary examinations to make the best anesthesia decision for you.

When you fill out your pre-anesthesia questionnaire, it is critical that you give detailed information about your health history and family history including any difficulties with anesthesia and allergies. You will also need to list of all the drugs you are taking and their doses including prescriptions, over-the-counter medicines and herbal remedies, recreational drugs, tobacco, and alcohol. This information will help your anesthesia provider select the appropriate drugs to avoid drug interactions.

Will the surgery be performed in a hospital, surgical suite/ambulatory surgical center (ASC) or doctor's office on an inpatient or outpatient basis?
Inpatient care requires a short or extended hospital stay. Outpatient or ambulatory care allows you to go home the same day as your surgery.

There is an increasing trend to perform certain procedures in physicians' offices and outpatient surgical suites. Ask your physicians about the hospitals that they are affiliated to practice in and find out about their specialties and medical certifications.

The same stringent standards for anesthesia should be followed in any setting where anesthesia is administered. The regulatory oversight of offices is not, in general, as stringent as for hospitals. Make sure that trained medical anesthesia professionals will closely monitor you during your surgery and recovery period.

In any setting, it is important that you thoroughly investigate the certification of the facility. Make sure that you have access to information regarding practitioners' qualifications, training, licenses, equipment, monitoring devices and procedures, and policies.

All patients that receive anesthesia should have their heart rate, temperature, blood pressure, oxygen concentration, and breathing closely monitored during surgery and recovery periods. Anesthesia providers should use a pulse oximeter to measure the blood oxygen levels and capnograph to measure carbon dioxide levels. Vital signs should continue to be monitored for one to two hours after surgery.

All anesthesia providers should monitor the temperature in patients given general anesthetics and during any major surgery of any kind.

Ask your surgeons and anesthesia providers about their documented emergency procedures. Make sure they have a crash cart with airway equipment, a defibrillator and non-expired drugs including adrenaline.

In an office or surgical suite setting, find out about emergency plans for transfer in case of emergency to the associated hospital's emergency room or intensive care unit. It should take less than 30 minutes to transfer patients to the hospital.

In the operating and recovery rooms, your anesthesia providers need to be prepared to correctly identify and treat any anesthesia complications including malignant hyperthermia. Make sure that they are trained to follow the MH pre-operative and intra-operative treatment protocol provided by MHAUS. Ask them if a designated cart containing 36 vials of the antidote dantrolene and additional medications and equipment as recommended by MHAUS will be immediately available in the anesthetizing and recovery areas.