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Office Based Transfer Plan - OBTOCG

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Item: Laminated poster (pictured) and non-laminated checklist
Item Code: OBTOCG
Last revised: 2013
Printed: Color
Size: inches: 17 x 22
Language: English
Description: Guidelines to help office-based surgery facilities develop an emergency plan for transferring patients with suspected malignant hyperthermia (MH) have been developed. The guidelines are intended for facilities that are not capable of providing extended tertiary care for such patients, and will therefore depend on a separate receiving healthcare facility to do so. They are also separate and distinct from the diagnostic treatment guidelines for MH, which are already published by the Malignant Hyperthermia Association of the United States (MHAUS). 
 
The guidelines cite four (4) suggested steps for the transfer of patients from office-based surgery facilities. Steps one (1) and two (2) cite the recognition of a suspected episode of MH, discontinuation of triggering agents, and initiation of treatment as per MHAUS guidelines previously mentioned. Such guidelines involve MHAUS's "Emergency Therapy for MH” protocol criteria (see www.mhaus.org) or clinical signs such as elevated endotracheal CO2, muscle rigidity, hyperthermia, or exposure to triggering agents. Steps three (3) and four (4) cite implementation of the emergent MH transfer plan (after reviewing transfer considerations and capabilities) and notification to the receiving healthcare facility. With respect to receiving healthcare facilities, existing transfer agreements, inpatient capabilities, and consultants potentially available should be reviewed. Data to be reported (see summary of Emergent Transfer Care Plan Checklist below) as well as transport team capabilities should be reviewed. Implementation of the transfer decision emphasizes that transfer of such patients should not be optional and coordination of communication is essential.
 
The Emergent Transfer Care Plan Checklist was also developed in conjunction with the guidelines above, as a potential format to document pre-transfer events and their implementation times. The checklist details considerations during the recognition of the MH episode, transport team information, treatment, data to be collected, personnel to communicate with, and other pertinent information to be documented.
 
Both guidelines are the result of a collaborative effort launched by the Society of Ambulatory Anesthesia (SAMBA) and MHAUS. The guidelines, in summary, help office-based surgery facilities ensure they have a comprehensive plan in place to transfer suspected MH patients and to take into account the resources and capabilities available to them. Such an evaluation of processes will likely uncover potential pitfalls  which may lead to a lessened chance of survival by these patients.
 
For more information, visit www.mhaus.org and/or www.sambahq.org.
 
References:
1. "Developing an Emergent Transfer Care Plan for Suspected Malignant Hyperthermia”.  Copyright SAMBA and MHAUS. 2012
2. "Emergent Transfer Care Plan Checklist”. Copyright SAMBA and MHAUS. 2012
 
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