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Local anaesthetic systemic toxicity — DIPIMC MCQ

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HardResuscitationLocal anaesthetic systemic toxicityDIPIMCDipIMC

During wound infiltration with a large dose of local anaesthetic, a patient develops generalised seizures followed by cardiovascular collapse.

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Correct answer: A — Give intravenous lipid emulsion alongside standard resuscitation.

Local anaesthetic systemic toxicity causing seizures and cardiovascular collapse is treated with intravenous lipid emulsion in addition to standard resuscitation, and prolonged resuscitation may be required. Flumazenil has no role because the seizures are not related to benzodiazepines. In arrest from this cause, adrenaline doses are often reduced and lipid emulsion is the specific therapy.

Reference: Resuscitation Council UK Guidelines (2025)