Date of Award

Spring 5-2024

Document Type

DNP Project

Project Team Faculty Member

Dr. Mary Zerlan

Project Team Faculty Member

Dr. Matthew Bednarchik

Keywords

LAST, protocol, Local Anesthetic Systemic Toxicity, emergency, intralipid therapy

Abstract

LAST is an uncommon but deadly complication of local anesthetic administration. Healthcare facilities benefit from protocol implementation to help streamline best evidence-based practice. The American Society of Regional Anesthesia and Pain Medicine warrants a LAST emergency protocol for any healthcare facility practicing regional anesthesia. Healthcare personnel encountering patients at risk for LAST must understand the symptoms and treatment of LAST to improve response time and patient outcomes. The project implemented a LAST protocol at a rural hospital in Southern Illinois in July 2023. The investigator held an educational service to discuss the new LAST protocol and implementation. The educational service included a PowerPoint presentation highlighting essential local anesthetic systemic toxicity and protocol information. Education provided healthcare personnel with information regarding LAST identification and treatment, which is paramount for improving patient outcomes. This project educated staff on where to find the necessary equipment to treat LAST, including a grab-and-go LAST emergency response bag with intralipids and a step-by-step treatment guide. Participants were asked to complete a pretest before the educational service and a post-test after to assess the efficacy of the presentation. There was significant improvement between the pretest and post-test scores, indicating increased LAST knowledge and provider comfort in responding to a LAST emergency. These results support the positive impact of implementing a LAST protocol and providing education for this rare emergency. The results of this project suggest an improvement in provider knowledge and comfort levels when responding to a LAST emergency, which may result in improved patient outcomes.

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