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Local-anesthetic systemic toxicity after block injection

Educational use only. Not clinically reviewed

42-year-old woman for Open reduction after planned upper-limb block. About 8 simulated minutes.

What you will practise

  • Recognize neurologic and cardiovascular toxicity after local-anesthetic exposure.
  • Deliver high inspired oxygen with active ventilation and suppress modeled seizure activity.
  • Start the ASRA 2020 weight-banded initial 20% lipid-emulsion protocol.
  • If epinephrine is used, keep the initial IV bolus at or below 1 microgram/kg and reassess.

Review and sources

Not clinically reviewed. No clinician has signed this scenario.

  • Neal JM, Neal EJ, Weinberg GL. American Society of Regional Anesthesia and Pain Medicine Local Anesthetic Systemic Toxicity checklist: 2020 version. Reg Anesth Pain Med 2021;46:81-2. PMID 33148630

Every scenario in this module

Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.