Signs/Symptoms
A potential early symptom. The patient may experience this kind of taste in their mouth.
What is Metallic.
It's the first tine treatment and this medication is believed to reduce the concentration of the local anesthetic in the bloodstream.
What is lipid infusion or 20% lipid emulsion.
LAST abbreviation stands for...
What is Local Anesthetic Systemic Toxicity
Where do we keep the Lipid Emulsion (Intra-Lipid) in Pre/Post?
What is the Anesthesia Block Cart in Pod 4.
A potential early symptom regarding the patient's hearing. They may report this symptom to you.
What is tinnitus or ringing in the ears.
This class of medication may be ordered to treat seizures that results from LAST.
What is Benzodiazepines. (Note: Often 2mg IV Midazolam.)
60% incidence of LAST occur in hospital setting, but name two other outpatient settings where LAST may occur?
What are outpatient Ambulatory Surgery Centers (ASCs), outpatient urology clinics, cosmetic surgery clinics, dental offices, etc.
It is determined the patient has LAST. After the provider has stopped injecting local anesthesic, what is the team's the next step?
What is "Call for Help" and ask for the lipid emulsion.
A potential early symptom where the patient reports numbness to this area of their body.
What is peri-oral paresthesia or numbness to mouth, tongue, lips, etc.
Once the patient is hemodynamically stable, the goal is to continue the lipid emulsion for at least this many minutes.
What is 15 minutes.
Beware LAST Resuscitation is different than what?
What is Standard ACLS.
After calling for help to get the Lipid Emulsion, name 2 interventions to perform to help your LAST patient that are not medication related.
What is Applying 100% O2 via facemask, maintain patient's airway, safely re-positioning the patient to flat supine position, more frequent vital signs, etc.
Name one potential CVS symptom associated with LAST?
What is Bradycardia, AV block, Tachyarrhythmias, Hypotension or Cardiac Arrest.
In addition to a Lipid Emulsion Infusion, the "LAST Checklist" recommends giving a patient (over 70kg) a Lipid bolus of this amount.
What is ~ 100ml.
According to the video, Incidence of LAST happens 1-2 occurrences per how many Nerve Blocks.
What is 1,000?
The patient who experienced LAST is now stable. It is recommended to monitor the patient (who had only neuro/CNS symptoms) for how long?
What is 2 hours.
As local anesthetic concentration increase (in the patient's plasma), the patient with LAST may experience Neuro/CNS related symptoms. Name 2 of these symptoms.
What is agitation, restlessness, muscle twitching, seizures and/or unconsciousness, etc.
According to the assigned article, this medication should not be used to treat dysrhythmias because it can worsen the symptoms of LAST.
What is Lidocaine.
Lipid Emulsion is also stocked in the PACU & OR Sterile Core Acudose Cabinets. Why?
What is "Because LAST can occur in the Operating Room (or after in recovery) when the surgeon/proceduralist injects local anesthetic at the surgical site."
Name 1 safe local anesthetic practice providers may do to decrease the risk LAST.
What is Being conscious of local anesthetic dose limits, using the lowest dose that gets the job done, aspirating before injecting, using ultrasound guidance, and adding 2.5mcg/ml epinephrine as marker, etc.