07 / Anaesthesia · Crisis drills
Crisis drills
13 algorithms in 5 groups, hidden one step at a time. Decide your move, then reveal the algorithm’s: reading one is not the same as being able to run one.
Local anaesthetic systemic toxicity
Intravascular injection or absorption of a large local anaesthetic dose
Recognise it
- Perioral tingling, metallic taste, tinnitus and visual disturbance early.
- Agitation, confusion and then seizures.
- Bradycardia, broad complexes, ventricular arrhythmias and arrest.
- It can present up to an hour after injection, not only immediately.
The usual mistake
Treating an unexplained seizure or arrhythmia after a block as anything other than toxicity until the lipid is running.
On the cart
Do it in order
0/61Hidden until you have committed
2Hidden until you have committed
3Hidden until you have committed
4Hidden until you have committed
5Hidden until you have committed
6Hidden until you have committed
Decide your first move before you reveal it. Rehearsing the order is the whole point: in a real crisis the failure is jumping to step four.