"How do I introduce lipid therapy at my facility"?
We often encounter this question from people who've just heard of lipidrescue and want to know what to do at the outset. The first thing to do is contact your hospital's pharmacy and request they stock 20% lipid emulsion at sites where regional anesthesia is used. This could be kept in a drug (Pyxis) or equipment (Omnicell) dispensor in the recovery room, or block room.....anywhere with rapid access from where you do your injections. It will often help if you've figured out the best logistical location before contacting the pharmacist. Similarly, the pharmacist is likely not to have heard of the technique, so it will help if you come armed with a couple of articles (see links to literature). A case report (e.g., Dr. Rosenblatt's or Dr. Litz's), letter or editorial will probably help, too. If you're at a very academic location, go with an animal study for something that has a little scientific bite to it. You will probably want to have at least 500 mL and in all probability, Intralipid brand, only because this is the stuff all the studies were done with. We're not sure at this point if the other lipid emulsion preps have equal or superior efficacy since those experiments haven't been done yet. You'll also want some large, luered syringes (50-60 mL) and an infusion kit (macrodrip). It also makes sense to attach some laminated instructions.