Date of Award

Spring 5-4-2018

Document Type

DNP Project

Project Team Faculty Member

Rebecca Collier

Project Team Faculty Member

Mary Zerlan


Local Anesthetic Systemic Toxicity, LAST, Lipid Emulsion, Lipid Rescue, Simulation, LAST Simulation


When local anesthetics are administered at toxic doses or when certain local anesthetics are directly injected into the patient’s circulation, excessive plasma concentrations of the drug will produce a systemic cascade of events known as local anesthetic systemic toxicity (LAST). LAST is a rare, potentially life-threatening complication, which affects both the central nervous and cardiovascular systems. Anesthesia providers and perioperative healthcare professionals must remain current on best practice LAST management in order to reduce morbidity and mortality.

This quality improvement project utilized high fidelity simulation paired with LAST education to improve stakeholder knowledge and management of a LAST scenario. With high-fidelity simulation participants received constant feedback after intervention during LAST recognition and treatment. Simulations took place in the OR, PICU, and Adult ICU. The hospital staff included in the sample received a 20-minute educational presentation followed by the high-fidelity simulation. A total of 61 providers including nurse anesthetists, nurses, support staff, student nurses, and nurse anesthesia students participated in this project. The data gathered from the evaluation questionnaires inferred this project was successful in teaching the participants how to diagnose and properly manage a LAST, which ultimately could lead to better patient outcomes.

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