Local Anaesthesia Toxicity (LAST)

  • The key in managing LAST is prevention. Know your dose, know your maximum dose, always aspirate prior to injection and ask patient about symptoms
  • Lidocaine toxicity cardiovascular complications are typically preceded by neurological signs/symptoms. If these develop, stop administration, place patient on monitor and ready your antidote
  • Bupivacaine toxicity can be sudden and catastrophic. If you are using the drug, undershoot your max dose and know where your antidote is
  • Intralipid has been shown to be effective in LAST. Administer the drug anytime there are signs of hemodynamic compromise

 

EMKF

The Emergency Medicine Kenya (EMK) Foundation is a not-for-profit organization registered in Kenya in 2015 that aims to ensure timely, accessible and quality lifesaving emergency care in Kenya.