Date of Award


Document Type


Degree Name

Doctor of Nursing Practice (DNP)




John Chovan, Ph.D.

First Committee Member

Regina Prusinski, DNP

Second Committee Member

Kacy Ballard, DNO

Third Committee Member

Donna Doyle, DNP


Labor and Delivery, Hypothermia, Neuraxial Anesthesia

Subject Categories

Maternal, Child Health and Neonatal Nursing | Medicine and Health Sciences | Nursing | Nursing Midwifery


Malignant Hyperthe1mia (MH) is a rare, inherited disorder of skeletal muscle triggered by general anesthesia in susceptible individuals. Although MH can occur later in the anesthetic course as well as post-operatively, it most frequently occurs shortly after induction of general anesthesia. Operating roo1n (OR) nurses receive extensive training in MH crisis 1nanagement. On labor and delivery (L&D) units, neuraxial (spinal and epidural) blocks are the safest and 1nost co1nmonly used anesthetics during pregnancy. General anesthesia is utilized only when the life of the 1nother or infant is in jeopardy or when a neuraxial block is not possible. Under these circumstances, inhalational agents and succinylcholine, both MH triggering agents, are routinely administered. Because general anesthesia is used infrequently in pregnancy, L&D nurses are less likely to encounter a MH crisis than OR nurses and are at risk of being unprepared for this rare, life- threatening event. At a mediun1 sized, central Ohio trauma center, nurses are required to complete an online MH learning module annually. This learning 1nodule outlines the causes, signs, and sy1npto1ns of MH. In addition to the online learning 1nodule, OR nurses participate in a MH simulation drill where they practice hands-on MH crisis management skills. L&D nurses do not receive this additional training and could benefit from a MH simulation drill. A hands-on MH sin1ulation drill was created for the L&D environment to be utilized in conjunction with the online MH learning module. In the simulation drill, L&D nurses practiced skills not covered in the online learning module. The L&D nurses practiced their roles in the event of a crisis, located the MH cart, reconstituted dn1gs needed, and contacted appropriate help. The sin1ulation drill afforded L&D nurses the opportunity to practice using low frequency, skills to prepare for a MH crisis. After participating in the drill, paired T -test results show improved MH crisis management skills in L&D nurses.



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