FRCEM Intermediate Staff asked 2 years ago
A.What is the likely diagnosis and what is the most important immediate management step? (1 mark)
B.The patient becomes pale and poorly responsive. A member of the nursing staff informs you the patient’s blood pressure is unrecordable, however, they can feel a weak central pulse. What drug should be considered in this patient? (1 mark)
C.How to decrease Risk? (1 mark)
FRCEM Intermediate Staff answered 2 years ago
Local anesthetic toxicity
Stop injecting or infusion and Call for help
B.
Give 1-1.5 ml/kg IV Lipid emulsion 20% as an IV bolus over 1 minute
C.
know your maximum doses
aspiration before injecting avoid injecting intravenous or intra-arterial
small, divided doses
inject slowly & ask about symptoms
Higher doses can be used is co-administered with adrenaline to reduce systemic absorption of LA
increased LA effect in –avoid in acidosis, hypoxia, hypercarbia
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