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Question preview · USMLE Step 3

Minutes after succinylcholine and sevoflurane are given for emergency surgery, a 19-year-old develops generalized rigidity, rapidly rising end-tidal carbon dioxide despite increased ventilation, tachycardia, and temperature 39.1°C. Which immediate treatment bundle is most appropriate?

  1. A. Stop surgery, increase ventilation, and administer intravenous bicarbonate
  2. B. Stop triggers, give 100% oxygen, and administer intravenous dantrolene
  3. C. Stop triggers, begin active cooling, and administer intravenous bicarbonate
  4. D. Stop succinylcholine, begin active cooling, and administer intravenous calcium
  5. E. Stop sevoflurane, change the circuit, and administer intravenous bromocriptine

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