Local anesthetic toxicity: quiet warnings can turn fast
Educational use only. Not clinically reviewed62-year-old woman for delayed source, prodrome, seizure, cardiac-risk, rescue-intent, reassessment, and handoff practice. About 6 simulated minutes.
What you will practise
- Reconcile source, clock, prodrome, seizure, cardiac, and whole-patient findings.
- Recognize the coupled LAST pattern without classic-sequence-, clock-, symptom-, or ECG-only closure.
- Activate source, airway, seizure, cardiac, toxicology, lipid, and refractory-rescue ownership.
- Review supplied source-delivery, CNS, ECG, perfusion, acid-base, electrolyte, and differential evidence.
- Record bounded qualified source, airway, seizure, lipid, acid-base, modified-resuscitation, and ECLS intent, then review a strict later report.
- Hand off recurrent seizure, arrhythmia, shock, airway, acidemia, source, lipid, and refractory risk.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Neal JM, et al. Third ASRA Practice Advisory on Local Anesthetic Systemic Toxicity. Reg Anesth Pain Med. 2018;43(2):113-123.
- American Heart Association. 2025 Guidelines for CPR and ECC. Part 10, Local Anesthetics.
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.