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A Simplified Protocol for Intralipid Administration in the Emergency Dept.

By Arun Nagdev, MD; Justin Moore, MD; David Martin, MD; Kaitlen Howell, MD and Mikaela Chilstrom, MD, FACEP | on May 10, 2025 | 0 Comment
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The printed version of this article, which appeared on p. 18 of the May 2025 issue, contained superfluous text in the opening paragraph. The printed version was also modified under the section “Highland ED Protocol for Intralipid Administration.”

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Dr. Nagdev is an attending physician Highland Hospital/Alameda Health System.

Dr. Moore is an attending physician Highland Hospital/Alameda Health System.

Dr. Martin is an attending physician Highland Hospital/Alameda Health System.

Dr. Howell is an attending physician Highland Hospital/Alameda Health System.

Dr. Chilstrom is clinical faculty of emergency medicine, Los Angeles General Medical Center.

References

  1. Goldsmith A, Driver L, Duggan NM, et al. Complication Rates After Ultrasonography-Guided Nerve Blocks Performed in the Emergency Department. JAMA Netw Open. 2024:7(11):e2444742.
  2. Farrow RA, Shalaby M, Newberry MA, et al. Implementation of an Ultrasound-Guided Regional Anesthesia Program in the Emergency Department of a Community Teaching Hospital. Ann Emerg Med 2024:83(6)509-518.
  3. Merz-Herrala J, Leu N, Anderson E, et al. Safety and Pain Reductiont in Emergency Practitioner Ultrasound-Guided Nerve Blocks: A One-Year Retrospective Study. Ann Emerg Med. 2024,83(1):14-21.
  4. El-Boghdadly K, Chin KJ. Local anesthetic systemic toxicity. Continuing Professional Development. Can J Anesth Can Anesth. 2016:63(3):330-349.
  5. El-Boghdadly K, Pawa A, Chin KJ Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth. 2018:11:35-44.
  6. Becker DE, Reed KL. Local anesthetics review of pharmacological considerations. Anesth Prog. 2012:59(2):90-101; quiz 102-103.
  7. Vasques F, Behr AU, Weinberg G, Ori C, Di Gregorio G. A Review of Local Anesthetic Systemic Toxicity Cases Since Publication of the American Society of Regional Anesthesia Recommendations: To Whom It May Concern: Reg Anesth Pain Med. 2015:40(6):698-705.
  8. Morwald EE, Zubizarreta N, Cozowicz C, Poeran J, Memtsoudis SG. Incidence of Local Anesthetic Systemic Toxicity in Orthopedic Patients Receiving Peripheral Nerve Blocks. Reg Anesth Pain Med. 2017:42(4):442-445.
  9. Liu SS, Ortolan S, Sandoval MV, et al. Cardiac Arrest and Seizures Caused by Local Anesthetic Systemic Toxicity After Peripheral Nerve Blocks: Should We Still Fear the Reaper? Reg Anesth Pain Med. 2016:41(1):5-21.
  10. Karaca O, Pinar HU. Is high dose lumber erector spinae plane block safe? J Clin Anesth. 2020;62:109721.
  11. Yawata S, Imamachi N, Sakura S, Yamamoto H, Saito Y. Local anesthetic systemic toxicity of levobupivacaine in erector spinae plane block. Korean J Anesthesiol. 2021;74(3):271-272.
  12. Checklist for Treatment of Local Anesthetic Systemic Toxicity: ASRA Pain Medicina November 1, 2020. Available at: https://www.aira.comvnews publications/asra-updates/blog-landing/guidelines/2020/11/01 Ashacklist for-treatment-of-loc-anesthetic-systemic-toxicity. Accessed 30, 2025.

Pages: 1 2 3 4 | Single Page

Topics: Anesthetic ComplicationsIntralipid TherapyLocal Anesthetic Systemic ToxicityUltrasound-Guided Nerve Block

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