ESRA Academy. Merjavy P. Sep 8, 2016; 138597; 0478 Topic: Local Anaesthetics - Systemic Toxicity
Disclosure(s): No conflict of interest declared
Dr. Peter Merjavy
Dr. Peter Merjavy

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Background and Aims:

The administration of Intralipid™ Emulsion (ILE) is a well recognised treatment for local anaesthetic systemic toxicity (LAST).1 

ILE and a plan for LAST management should be readily available in any facility where local anaesthetics are used.2

Our recent audit revealed several issues: inappropriate storage, inappropriate volume, lack of attached AAGBI guidelines, staff unaware of ILE location. This gives rise to the risk of delay in treatment delivery and/or inadequate dose given for patients in critical condition.


We have created Lipid Rescue Kit Box containing: ILE, 50ml syringes, 16G venflons, giving set, guidance table and  AAGBI safety guideline. 

We have performed service evaluation of 10 trainees with simulated LAST scenario in operating theatres. We measured time taken for ILE to arrive in theatre; time to 1st bolus and time to starting ILE infusion. We have repeated the same scnenario one week later using Lipid Rescue Kit Box.Results:

Our data have improved efficiency of “time to Intralipid™ in theatre” by 47.5% (0:42 vs 1:20 min), “time to first bolus” by 47.1% (2:06 vs 3:58) and “time to start the infusion” by 39.3% (3:30 vs 5:46) when using Lipid Rescue Kit box compare to our previous standard. 


Oud data suggest, that in real life we would be able to deliver the bolus/infusion of Intralipid™ within 1st/2nd cycle of CPR using the Lipid Rescue Kit Box instead of 2nd/3rd cycle of CPR using our previous standard.

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