Fort Hood, Texas  –   At Carl R. Darnall Army Medical Center, training the next generation of health care professionals is more than a priority — it’s a responsibility. That includes preparing future anesthesia providers for the rarest, yet most critical, emergencies they could face in the operating room.

Recently, Student Nurse Anesthetist Capt. Byung (James) Jung, CRDAMC, participated in a high-fidelity simulation designed to test response and teamwork during a malignant hyperthermia (MH) event — a rare but potentially fatal reaction to certain anesthetic medications.

“I only found out about the simulation five minutes before it started, but that’s how it is sometimes in real life,” Jung said. “In anesthesia, things can change fast, so you have to think fast and be ready for anything.”
Malignant hyperthermia is an inherited reaction triggered by specific anesthesia drugs, such as succinylcholine and certain volatile gases. When it occurs, the body’s temperature can spike rapidly, potassium levels rise, and life-threatening arrhythmias can develop. Without immediate recognition and treatment, the condition can be fatal.

“It’s extremely rare — about one in 100,000 cases — but it’s so serious that rapid identification and response are critical,” Jung said. “You might never see it in your career, but you want to be ready if you do. That’s why thinking through the scenario in real time, even in a simulation, is incredibly valuable.”

The simulation, led by Dr. Jessica Ulinski, a board-certified nurse anesthetist, was part of the hospital’s annual Joint Commission–required training. Ulinski said these exercises are designed to keep staff sharp and ready for emergencies they may never actually see.

“We run this training with the OB (Obstetrician) team because MH is such a rare event, and they may not have encountered it before,” Ulinski said. “It’s important for everyone involved to be familiar with the medications and treatment algorithm so that if it ever happens, we’re all prepared to act quickly and as a team.”

As a teaching hospital, CRDAMC emphasizes hands-on learning and leadership development. For Jung, that meant stepping into the lead role — calling for help, assigning tasks, and managing the crisis as it unfolded.

“Anesthesia typically takes the lead in these situations because they’re monitoring the patient’s vitals and managing the airway,” Ulinski said. “For students like Jung, it’s an excellent opportunity to learn how to take charge, make decisions, and lead a team during a high-stakes scenario.”

Ulinski said simulations can be challenging because everyone knows it’s a drill, but the training works best when participants treat it as real.
“It’s about building confidence and teamwork,” she said. “The more realistic we make it, the more effective it becomes, and the better prepared our staff and students are to save lives.”

For Jung, the experience reinforced just how important training like this is.

“Being able to identify the problem and call for help is the key,” he said. “When everyone on the team works together, reminds each other of steps, and fills in any gaps, we can keep the patient safe. That’s why training like this matters.”