Background and aims Malignant hyperthermia (MH) is a rare pharmaco-genetic disorder triggered by potent volatile anaesthetic gases and Succinylcholine. This hypermetabolic state produces a mixed metabolic and respiratory acidosis associated with hyperkalemia, rhabdomyolysis and hyperthermia. Preoperative screening for MH susceptible patients would require a massive undertaking to determine who is at risk for an adverse event from exposure to potent inhaled anaesthetics. Based on the findings of the research done, Dr Tae W Kim and GE healthcare recommend steps to prepare GE healthcare anaesthesia system for MH susceptible patients.

Methods We have an MH treatment guideline laminated in the department. No guideline was available in our department to prepare anaesthesia machine for MH susceptible patients. It is a baseline audit as no local standards are available. This prospective audit was done in our hospital. We gave the questionnaire to anaesthesia doctors and ODPs and requested that they complete it.

Results We had 43 questionnaires filled by the end of audit between July-August 2018. More than 90% response was found in only 50% of questions related to recommendation for anesthesia machine preparation. Since MH is a rare condition, it is not possible to remember every detail to prepare the anaesthesia machine for known MH or MH susceptible patients.

Conclusions We decided, therefore, to put the recommendations in our departmental MH trolley. We also decided to develop a guideline/checklist for anaesthetic management of known MH or MH susceptible patients. We finally managed to develop pathway for all MH susceptible patients.