During a malignant hyperthermia crisis, what should be performed after discontinuing triggering agents?

• A. Hyperventilate with 100% O2
• B. Start Dantrolene
• C. Cool the patient
• D. Administer additional fluid bolus

Answer: (A)

Immediately providing 100% oxygen with aggressive ventilation is the best next step after stopping triggering agents because the body is in a state of extreme metabolic demand with rising CO2 and falling oxygen delivery. Hyperventilating with 100% O2 rapidly corrects hypoxemia and helps flush out CO2, reducing acidemia and limiting further tissue hypoxia while the team organizes definitive therapy. Dantrolene should be started as soon as it’s available and cooling and fluid management are initiated, but maintaining optimal oxygenation takes highest priority because without it organs remain at risk even as other treatments are prepared.