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Concerns

Causes

Signs and symptoms

Action

Causes

  • excess dose of local anesthetic
  • inadvertent intravascular injection of local anesthetic

Signs and symptoms

Early (1-5 minutes after injection)

  • light headedness
  • dizziness
  • disorientation
  • drowsiness
  • visual and auditory disturbances (tinnitus, difficulty focusing)
  • metallic taste

Late

  • muscle twitching
  • convulsions
  • unconsciousness
  • coma
  • respiratory distress and arrest
  • cardiovascular depression and collapse

Action

  • stop injection immediately
  • oxygen
  • attention to impending airway compromise, if so activate EMS
  • attention to significant hypotension, dysrhythmias, and seizures
  • manage specific symptoms
  • arrange for escort home

OK