Improving Awareness and Knowledge of Local Anesthetic System Toxicity Amongst Labor and Delivery Nurses: Through Education, Simulation, and Cognitive Aids

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Jaclyn Johnson (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Vadim Korogodo

Abstract: Background: Local Anesthetic Systemic Toxicity (LAST) is a high-acuity, low-occurrence medical emergency caused by increased plasma concentrations of local anesthetics. When early signs and symptoms such as tinnitus, confusion, and tingling around the mouth go unidentified, symptoms can quickly progress to respiratory and cardiac arrest. Although LAST events are infrequent, they contribute to maternal morbidity and mortality. Purpose: This project aimed to provide traditional education and simulation to increase awareness, knowledge, and confidence in recognizing LAST and providing prompt treatment to laboring mothers. Methods: Labor and delivery nurses received a PowerPoint presentation and a scripted LAST simulation. The project used a mixed-method cross-sectional design to collect data to evaluate awareness, knowledge, and confidence following the implementation. Results: Thirty-two labor and delivery nurses participated in the implementation of this project, and fourteen of the thirty-two participants participated in the one-month follow-up surveys. Data collected by the pre-and post-surveys were analyzed using paired t-tests for two samples. All participants had increased awareness and knowledge of LAST, and most had increased confidence after the intervention. Conclusion: Results indicated that the intervention effectively increased awareness, knowledge, and confidence in identifying and managing a LAST event. By having more awareness, knowledge, and confidence in managing LAST, maternal morbidity and mortality should decrease during a LAST event. It is recommended that labor and delivery floors implement formal training along with simulation to create more awareness of LAST and to increase knowledge and confidence in managing a LAST event.

Additional Information

Publication
Other
Language: English
Date: 2024
Keywords
local anesthetics, local anesthetic systemic toxicity, LAST, maternity, obstetrics, parturient, simulation-based training, intralipids, emergency checklist

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