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QUAD AJan 24, 2024 6:02:16 PM1 min read

Malignant Hyperthermia Requirements When NO Triggering Agents Are Present

The requirements for Malignant Hyperthermia (MH) can often be confusing, especially if a facility does not have inhalation gases such as isoflurane, sevoflurane, and desflurane present on site or when the depolarizing muscle relaxant succinylcholine is used or present only for use in emergency airway rescue.

If your facility is a QUAD A Medicare Ambulatory Surgery Center (ASC), or a non-Medicare Office-Based Surgery, and is class C-M, or C, and you do not have any inhalation gases or succinylcholine present, then only the following two (2) QUAD A MH-related standards apply:

  • 5-A-2 - The current and complete MHAUS malignant hyperthermia algorithm must be available on the emergency cart.
  • 5-C-5 - There must be a written protocol for malignant hyperthermia (MH).

If your facility is an Office-Based Procedural facility class C-M, or C, and you do not have any gases or succinylcholine present, then only the following one (1) MH-related standard applies:

  • 5-A-2 - The current and complete MHAUS malignant hyperthermia algorithm must be available on the emergency cart.

MH standards do not apply to facility classes A and B.

We hope this information clarifies what is needed for facility compliance with our standards related to MH when there are no gases or succinylcholine present. Should you have any questions, please email them to standards@quada.org.


Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.

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