BACKGROUND: Local anesthetic systemic toxicity (LAST) is a rare but life-threatening complication of anesthetic administration. Nurses are often the first to observe subtle signs of toxicity, yet studies show gaps in knowledge and preparedness. This integrative review was conducted to evaluate effective educational strategies for clinicians to identify and manage LAST in the clinical setting. METHOD: A total of 13 articles were selected for inclusion based on their relevance to LAST education. RESULTS: Thirteen studies met the inclusion criteria. Four primary educational strategies were identified: didactic instruction, simulation-based learning, web-based modules, and cognitive aids. All modalities showed significant short-term improvement in knowledge. Combined approaches, particularly simulation with didactic instruction, showed the strongest outcomes. Knowledge decay was identified as a persistent challenge, with only five studies assessing retention beyond 3 months. CONCLUSION: Preparing nurses and students for LAST requires integrated strategies that combine accessible content with experiential practice. Future research should emphasize long-term knowledge retention and innovative modalities to strengthen LAST education.
Adams et al. (Tue,) studied this question.