{
  "abstract": "Background and Aims Local Anaesthetic Systemic Toxicity(LAST) remains a serious but preventable perioperative complication. Following a fatal incident linked to an overdose during elective orthopaedic surgery, we identified a critical gap in clinicians’ understanding of maximum safe local anaesthetic(LA) dosing, documentation, and communication practices. This project aimed to improve education and team-based strategies for safe LA dosing in elective lower limb joint replacements.Methods A departmental survey was conducted among anaesthetists and surgeons to assess current knowledge, dosing calculations, and perioperative communication around LA use. A retrospective audit of 87 patients undergoing total hip and knee replacements(June–July 2024) across two hospital sites evaluated real-world compliance with documentation and safety standards. Educational interventions were introduced, including: • Visual dosing charts • Multidisciplinary teaching during theatre briefings • Promotion of two-person dose verification This was followed by a Plan-Do-Study-Act(PDSA) cycle to prepare for re-audit and outcome measurement.Results • 32% of cases had full LA dose documentation. • One patient received a 135% overdose of the recommended maximum. • 69% of staff surveyed were not using calculators, charts, or other aids. • 46% did not routinely discuss LA dosing with the team prior to administration. • Educational tools were positively received, especially by trainees and ODPs. Our findings reveal significant variability and lack of standardisation in LA dosing practices. Educational interventions that combine cognitive aids, simulation-based training, and interprofessional learning can improve safety behaviours. Introducing mandatory tools such as LA dose charts, incorporating them into team huddles encourages a shared responsibility approach and reduces reliance on memory or individual estimation.Conclusions This project highlights the importance of targeted teaching to improve safety in regional anaesthesia. Key recommendations include: • Incorporating LA safety teaching into trainee curricula • Standardising use of visual aids and calculation tools • Embedding LA dose checks into team time-outs • Encouraging multidisciplinary learning environmentsAbstract EP078 Figure 1Guide to local anaesthesia dosing and local anaesthesia equivalency charts",
  "authors": [
    {
      "affiliations": [
        "Anaesthetics, Hillingdon Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Kush Amin"
    },
    {
      "affiliations": [
        "Anaesthetics, Hillingdon Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Shveta Kajal"
    },
    {
      "affiliations": [
        "Anaesthetics, Hillingdon Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Pooja Kamath"
    }
  ],
  "title": "EP078 Teaching for safety: enhancing education on local anaesthetic dosing in elective lower limb surgery",
  "uid": "53492b2e-d69e-5688-9974-318654898802"
}