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IMPLICATIONS: Relying on memory to treat a rare event can result in omissions and treatment missteps. We evaluated the use of cognitive aids in a simulated anesthetic crisis (malignant hyperthermia) to determine if their use improved performance.

Malignant hyperthermia (MH) is a rare genetic disorder of metabolism that, when triggered by drugs used in anesthesia, creates a major crisis. The incidence of MH ranges from 1 in 62,000 to 1 in 84,000 for general anesthetics in which succinylcholine and inhaled anesthetics are used (1). With this incidence, most anesthesia professionals will never treat a case of MH during their career. Once the diagnosis of MH has been made, a complex and specific treatment plan needs to be implemented quickly and efficiently to prevent a fatal outcome. A treatment scheme has been produced by the Malignant Hyperthermia Society of the United States (MHAUS; www. mhaus. org …