106 Local Anaesthetic Toxicity and its Treatment in the Plastic Surgery Minor Op Theatre

Abstract

Abstract Objectives Local anaesthetics (LA) are frequently used in Plastic Surgery; hence knowledge of the recognition and treatment of LA toxicity is vital amongst all staff members. Our study aimed to identify and improve the understanding of local anaesthetic toxicity and its treatment amongst plastic surgery staff in our minor operations theatre. Method The BNF and AAGBI guidelines on LA toxicity were used as our audit standards. In the initial cycle, we performed 1–1 interviews, using an 11-point questionnaire, with 11 doctors and 7 nurses over two days. Interventions to improve our service included organising a structured departmental teaching on LA toxicity; displaying official AAGBI posters around the department; and including information on LA toxicity in the junior doctor's handbook. A re-audit was performed 1 month later. Results After the interventions, the knowledge on safe doses of LA improved from 57% to 100%. All staff knew signs and symptoms of LA toxicity (up from 67%). An improvement was also seen in the knowledge about monitoring and treatment of LA toxicity, from 39% to 100%. Surprisingly, only 17% knew the location of intralipid within the department during the initial cycle, however this figure improved to 100% after the interventions. Conclusions Knowledge of LA toxicity and its treatment is vital for all Plastic Surgery staff, especially in a minor operations theatre. The use of structured teaching sessions, posters about LA toxicity, and information in junior doctor's handbook, are useful interventions in improving the know-how amongst all staff members.