Malignant hyperthermia emergency consultation: preliminary results from 'hotline' calls

Objective

To demonstrate the functioning of the only 24-h call system in Brazil for help in hyperthermia malignant cases.

Method

Between February 2000 and February 2001, all the phone calls to 'hotline' were analyzed. We examined the index-card filled out by the doctors who worked in the ICU and were responsible for the hotline calls.

Results

We registered 60 calls during this period, and all were reported in the index-card. There were 50 calls (83.4%) done by health care professionals, including 43 (86%) physicians, four (8%) nurses and three (6%) pharmacists. The Southeast region of Brazil was responsible for 78.3% of all calls, including 89.36% from São Paulo. The most frequent doubt presented by phone was about the purchase and administration of Dantrolene^® (30%). The other calls were about suspected but not confirmed cases (16.7%), prophylaxis and diagnosis (21.7%), preoperative evaluation in susceptible patients (10%) and general scientific information about the disease (6.7%). The main objective of the 'hotline' was to direct the assistance in confirmed cases of malignant hyperthermia. We had seven (11.6%) calls that were related to malignant hyperthermia cases.

Conclusions

Malignant hyperthermia is still a disease with high morbidity and mortality, which is poorly diagnosed and inappropriately treated. The maintenance of a 'hotline' system 24 h/day is justified not only because of the emergency characteristic of the disease, but also for complementary evaluation and information related to the diagnosis, treatment and prevention in susceptible patients.