Monitoring

If the patient has severe hyperthermia (rising temperature >38.5℃ despite conventional cooling methods) monitor their core temperature at least every 30 minutes (check your local protocol).[35]

While giving fluids, monitor the patient’s urine output. Aim for a target urine output of:[35]

  • 0.5 mL/kg/hour if the patient does not have rhabdomyolysis

  • ≥1 mL/kg/hour if the patient has rhabdomyolysis.

Monitor creatine kinase (CK) daily in all patients until their CK level and symptoms have resolved. Elevated CK is a sensitive indicator of muscle injury, which may cause subsequent myoglobinuric acute kidney injury.

If the patient has rhabdomyolysis, monitor their fluid balance, plasma sodium and potassium, urinary pH, and for the development of metabolic acidosis.[35] Be alert to severe hyperkalaemia.[35]

An episode of NMS should be noted in the patient's medical records as a life-threatening adverse drug effect.[8]​[12]​​[24]

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