Mindray A5 Operating Instructions

References Preparation for Malignant Hyperthermia Susceptible Patients
F - 4 046-003777-00 A5/A3™ Operating Instructions
The following guidelines are recommended by the Malignant Hyperthermia Association of
the United States (MHAUS)
*
Preparation of Anesthesia Workstations to Anesthetize MH Susceptible Patients
Recommendations (4 alternatives):
1. Flush and prepare workstation according to manufacturer's recommendations or published
studies; this may take 10 to >90 minutes. Most studies also physically disconnect vaporizers
from the workstation; use a new, disposable breathing circuit; and replace the carbon
dioxide absorbent. During the case, fresh gas flow should be kept at 10 liters per minute to
avoid "rebound phenomenon" (increased release of residual volatile anesthetic agent when
fresh gas flow is reduced after a set period of flushing). or
2. Use commercially available charcoal filters that have been shown to remove trace levels of
volatile anesthetic agents within 10 minutes of application, without additional preparation.
These filters may have to be regularly replaced during the anesthetic.
++
or
3. If available, use a dedicated "vapor free" machine for MH-susceptible patients. The machine
must be regularly maintained and safety-checked. or
4. If appropriate to the institution, use an ICU ventilator that has never been exposed to
volatile anesthetic agents.
For further information contact the Malignant Hyperthermia Association of the United States at http:/
/www.mhaus.org/
*
: Guidelines are excerpted from the MHAUS website and do not replace the indicated instructions for
preparation of the A5.
++
: This method has not been tested with A5.
F.4 References
1. Hopkins PM. Malignant hyperthermia: pharmacology of triggering. Br J Anaesth. 2011 Jul;
107 (1): 48-56.
2. Kim DC. Malignant hyperthermia. Korean J Anesthesiol. 2012 Nov; 63 (5): 391-401.
3. Kim TW, Nemergut ME. Preparation of modern anesthesia workstations for malignant
hyperthermia-susceptible patients: a review of past and present practice. Anesthesiology.
2011 Jan;114 (1):205-212.
4. Schuster F, Johannsen S, Schneiderbanger D, Roewer N. Evaluation of suspected malignant
hyperthermia events during anesthesia. BMC Anesthesiology 2013, 13: 24.
5. Gunter JB, Ball S, Tan-Win S. Preparation of the Dr?ger Fabjus anesthesia machine for the
malignant -hyperthermia susceptible patient. Anesth Analg 2008; 107: 1936-45.
6. Reber A, Schumacher P, Urwyler A. Effects of three different types of management on the
elimination kinetics of volatile anaesthetics. Implications for malignant hyperthermia
treatment. Anaesthesia 1993; 48: 862-5.
7. Crawford MW, Prinzhausen H, Petroz GC. Accelerating the washout of inhalational
anesthetics from the Dr?ger Primus anesthetic workstation. Anesthesiology 2007; 106:289-
94.
8. Prinzhausen H, Crawford MW, O'Rourke J, Petroz GC. Preparation of the Dr?ger Primus
anesthetic machine for malignant hyperthermia-susceptible patients. Can J Anesth 2006; 53:
885-90.

Mindray A5 Specifications

General

Brand	Mindray
Model	A5
Category	Medical Equipment
Language	English