Further, one can liken stopping the hyperthermia due to MH, NMS, and SS to a firefighter trying to extinguish a fire due to a ruptured gas main. One can spray fire retardant at the gas main in an attempt to stop the fire. However, if the gas flow is too great or if the wrong agent is used to try to extinguish the fire, failure will ensue.
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ACEP Now: Vol 36 – No 08 – August 2017On the other hand, if the firefighter simply turns the gas valve to “closed” for the ruptured gas line, the fire will stop.
Similarly, when we reach for rapid sequence or delayed sequence endotracheal intubation and non-depolarizing neuromuscular blockade, we stop the heat production at the source, rather than trying to guess which “extinguisher” drug will actually be effective.
The best way to put out a fire is to shut off its source. The best way to shut off hyperthermia is to eliminate its source by chemical paralysis.
Thank you for considering my views.
– Gary M. Gaddis, MD, PhD
St. Louis, Missouri
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