The National Patient Safety Agency of the British National Health Service just released a patient safety alert on epidural infusions (#21; March 28, '07). On page 5 of 8 they refer to lipid emulsion therapy and provide a link to this site in the references (#6). This is unquestionably the result, at least in part, of the combined efforts of John Picard and Tim Meek who have made a concerted effort to raise awareness of LipidRescue in the UK. This can be found at: http://www.npsa.nhs.uk/display?contentId=5760 , where you will look for the patient safety alert near the bottom of the page. You can also learn more at this link:http://www.npsa.nhs.uk/.

The month of March was a record setter! More than 1100 unique hits on lipidrescue.org exceeds our previous high of 714 visitors achieved last November. I would attribute this increased interest to the publication of letters-to-the-editor in last month's edition of Anesthesiology (see previous blog).

Mike Alway, RPh from BonSecours Hospital, Grosse Pointe, MI has been kind enough to send in photos of a home made LipidRescue kit he made from scratch for their ORs. Photos of the kit can be found under 'sample kit' (see navigator). This is an excellent example of how the community can contribute to and improve the site for everyone. Mike, way to go! The other means of improving the site's value is by posting cases, which is occuring with greater regularity now. These cases are invaluable in terms of what they teach us about context, cause and natural history of LA toxicity and efficacy of lipid and other therapies and combinations of treatments.  

The December 14, 2006 issue of ISMP (Institute for Safe Medication Practices) Medication Safety Alert newsletter (Acute Care Edition) carries on page 3 an article about lipid emulsion therapy. The relevance to clinical practice is underlined in the introduction to the article which recounts a fatal medication error where a young parturient received an intavenous infusion of bupivacaine. The nurse, who now faces criminal charges, inadvertantly infused a bag intended for epidural analgesia by having confused it with a dose of antibiotic. Interestingly, a sidebar in the same issue, refers to two cases of women who suffered fatal local anesthetic overdoses by topical adminstration of lidocaine/tetracaine creams for analgesia related to laser hair removal. The editors didn't see the connection, but all three patients (in the two articles, four patients if you include the unborn child) might have been saved with lipid infusions. It is very apparent from these cases that local anesthetic toxicity will continue to occur in the future, in and out of hospitals. Education about lipidrescue might reduce patient mortality and will be the focus of this site and blog. I believe it is  also important to consider the effects such horrific events have on the doctors and nurses involved as well as their family and friends. The magnitude of such ripple effects can't be underestimated and will be the topic of a future entry. Guy Weinberg.   

This website went live in July 06 and that month registered 110 unique visitors. Over the summer this number continued to increase and in the month of October we had 354 visitors. November saw 706 'uniques' and we're hoping the number of visitors continues to go up.  Since July, there have been a total of more than 24,000 raw hits to the site and the most popular pages after the 'Welcome' are the Learning Links, Background, and Treatment Regimens. People have also seemed to like the Youtube posts of experiments.

The main deficiency from my standpoint at this stage is the lack of commentary from readers. Please let us know your thoughts about the site and what could be done to improve it. We'd also like to hear about interesting cases and experiences with local anesthetic toxicity (in particular, the scenario, drugs, doses, symptoms and signs, etc). The site is intended to be useful and educational. It will be far more successful in both with your contributions. Guy