Simulation study comparing readability and effectiveness of the 2012 versus 2017 ASRA local anesthetic systemic toxicity checklists

Hsiung, Robert L.; Bean, H.; Stafford, Carrie E; Mulroy, Michael F.; Weinberg, Guy; Neal, Joseph M.

doi:10.1136/rapm-2020-101870

Cited by 4 publications

(5 citation statements)

References 5 publications

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“…Even though major factors of WSB are covered by the checklist, such as marking, and time out before every block, its presence hints towards its compliance. 17 Hsiung et al 18 showed that for a LAST checklist, using more words in a checklist reduces effectiveness. These data support using a more concise format, which means having a process flow format might lead to greater efficacy compared with a format with sequential management steps.…”

Section: Regional Anesthesiamentioning

confidence: 99%

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Why don’t clinicians use checklists?

Clebone Ruskin,

Ahmed,

O’Connor

et al. 2024

International Anesthesiology Clinics

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On the surface, the concept of clinical checklists is enticing in its simplicity. If a clinician would just take the correct steps, at the correct time, following a set protocol, we could achieve zero preventable patient harm, right? Unfortunately, real-world complexities interfere with this ideal. Every patient, surgical procedure, and clinical scenario is different. In this manuscript, we will first review the history of checklists in modern medicine and then dissect the reasons why clinical checklists are sometimes ineffective. Next, we will examine some specific situations where checklists can be useful, including regional anesthesia and critical events.But why would we want a checklist anyway? Despite these disadvantages, a well-thought-out, comprehensively tested, and regularly revised checklist can serve to aid the

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Section: Regional Anesthesiamentioning

confidence: 99%

“…Hsiung et al 18 showed that for a LAST checklist, using more words in a checklist reduces effectiveness. These data support using a more concise format, which means having a process flow format might lead to greater efficacy compared with a format with sequential management steps.…”

Section: Regional Anesthesiamentioning

confidence: 99%

Why don’t clinicians use checklists?

Clebone Ruskin,

Ahmed,

O’Connor

et al. 2024

International Anesthesiology Clinics

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“…The infusion of lipid emulsions binds free circulating local anesthetics and lowers plasma levels due to their high lipid solubility. The American Society of Regional Anesthesia and Pain Medicine (ASRA) publish its management recommendations concerning LAST on a regular basis to reflect new information, user input, and simulation [ 58 , 59 , 60 , 61 , 62 ]. Figure 3 reflects a part of a clinical system for managing LAST suggested by the American Society of Regional Anesthesia and Pain Medicine (ASRAPM).…”

Section: Management Of Adverse Reactionsmentioning

confidence: 99%

Lidocaine: A Local Anesthetic, Its Adverse Effects and Management

Bahar

Yoon

2021

Medicina

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The most widely used medications in dentistry are local anesthetics (LA), especially lidocaine, and the number of recorded adverse allergic responses, particularly of hazardous responses, is quite low. However, allergic reactions can range from moderate to life-threatening, requiring rapid diagnosis and treatment. This article serves as a review to provide information on LA, their adverse reactions, causes, and management.

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“…However, a simulation study published in Regional Anesthesia and Pain Medicine compared the 2017 LAST checklist with the 2012 version that it replaced and found no difference in effectiveness or readability. 4 The 2020 checklist's most important modification was conversion of the traditional bullet-pointed design to a process-flow format similar to the ASRA LAST smartphone application. 9 This change responds to some simulation participants who found portions of both the 2012 and 2017 checklists difficult to follow and wordy.…”

Section: Special Articlementioning

confidence: 99%

“…11 When some simulation subjects chose to use both LAST and ACLS checklists, the resulting confusion and missteps led to delayed and errant treatment. 4 Admonitions placed near the top of previous checklists did not eliminate this defect, thus the 2020 redesign incorporates a standard triangular caution symbol to emphasize therapeutic differences. We further simplified lipid emulsion dosing instructions in response to reported difficulties calculating weight-based dosing and timing of lipid administration, 3 which reflect practitioner preference for a level of precision that is unnecessary and unsupported by experimental studies.…”

Section: Special Articlementioning

confidence: 99%