Local Anesthetic Systemic Toxicity (LAST): Designing an Educational Effort for Nurses That Will Last

Abstract

To improve knowledge and raise awareness of nurses who assist certified registered nurse anesthetists or anesthesiologists with peripheral nerve block or spinal block procedures about a potential life-threatening local anesthetic systemic toxicity (LAST) event. An evidence-based practice project design. Nurses in units where nerve block procedures were performed (ie, postanesthesia care unit, preoperative, operating room, outpatient services, labor and delivery unit) received a pretest about their knowledge of LAST events, participated in a 30-minute educational session, and then completed a post-test. The data were analyzed for differences and statistical significance. Included in the test was a question about the nurse's comfort level with managing a LAST event. The findings demonstrated a knowledge deficit related to LAST events. The average of all three units combined pretest scores was 60% and post-test scores increased to 95%. The average comfort level of all three units was 3.5/10 (35%) before the educational in-service program and increased to 7.9/10 (79%) after education. Nurses working in units where nerve blocks are performed are lacking in knowledge of the signs and symptoms and the correct course of treatment for a LAST event. This could lead to poor outcomes of a very high-risk low-volume event.