P025

L.A.S.T. Stop Ambulatory Care

Date
April 22, 2022

Performing procedures is becoming a common practice in ambulatory care clinics. Providing comfort during these procedures often requires the patient to receive local anesthesia via injection. Clinics with providers such as dermatology, can use a substantial amount of local during certain procedures. With this practice becoming more frequent, the subject of L.A.S.T syndrome was introduced and questioned. Upon investigation it was discovered that there was lack of policy, protocol and education surrounding L.A.S.T syndrome in ambulatory care. L.A.S.T. syndrome, or local anesthetic systemic toxicity, is a serious life-threatening condition that can occur in any setting following the administration of local anesthesia. This must be rapidly recognized and treated to improve the patient’s chance of survival (AORN, 2021). Following the identification of this practice gap a team was developed. This team was tasked with obtaining the latest evidence-based practices and guidelines to establish a policy and protocol for rapid recognition and treatment of L.A.S.T syndrome in ambulatory care across the healthcare system. A policy and protocol based on EPB and guidelines was successfully developed, equipment and rescue medication were obtained, and nursing staff was provided education via in-services, educational materials and low-fidelity simulation. Expected outcomes included: Nursing staff will be able to recognize patient risk factors, monitor for and detect the early signs and symptoms of L.A.S.T, provide rapid treatment via the ASRA (2020) algorithm, and effectively transfer the patient to the next level of care following provided education and simulation. Implementation of this practice elevated staff confidence in recognition and management of L.A.S.T syndrome and improved ambulatory care procedural patient outcomes.

References
1) AORN. 2021. Local Anesthesia. Retrieved from: Local Anesthesia | AORN eGuidelines+ (aornguidelines.org)
2) ASRA. 2020. Checklist for Treatment of Local Anesthetic Systemic Toxicity. Retrieved from: Checklist for Treatment of Local Anesthetic Systemic Toxicity (asra.com)

Speaker

Speaker Image for Michelle Slater
Michelle Slater, DNP, RN, CNOR
Nurse Manager Specialty Care Operations, Veterans Administration

Related Products

Thumbnail for Multidisciplinary Efforts in Redesigning the Ongoing Competency Process of a Health System
Multidisciplinary Efforts in Redesigning the Ongoing Competency Process of a Health System
Purpose statement: This quality improvement project was conducted to redesign the ongoing competency process to improve clinical educator satisfaction and increase leader involvement…
Thumbnail for RN UTI Management: Primary Care Registered Nurse Evaluation and Management of Suspected Urinary Tract Infection (UTI)
RN UTI Management: Primary Care Registered Nurse Evaluation and Management of Suspected Urinary Tract Infection (UTI)
Purpose: To improve efficiency and standardize evidenced-based recommendations to manage patients reporting suspected urinary tract infections by registered nurses utilizing approved NMG protocol in primary care
Thumbnail for Code Lavender: A Holistic Choice of Support for Staff Resilience in an Ambulatory Care Setting
Code Lavender: A Holistic Choice of Support for Staff Resilience in an Ambulatory Care Setting
Emory Saint Joseph's Hospital long-standing mission is to provide compassionate, clinically excellent healthcare in the spirit of loving service to those in need, with special attention to the poor and vulnerable…
Thumbnail for Nurse-Driven Protocols Leverage Nursing Expertise and Expand Access to Marginalized Populations
Nurse-Driven Protocols Leverage Nursing Expertise and Expand Access to Marginalized Populations
Traditional physician-centered healthcare settings are structured such that there are long wait times for appointments and complex approval processes…
Privacy Policy Update: We value your privacy and want you to understand how your information is being used. To make sure you have current and accurate information about this sites privacy practices please visit the privacy center by clicking here.