Simulation Education in Anesthesia Training: A Case Report of Successful Resuscitation of Bupivacaine-Induced Cardiac Arrest Linked to Recent Simulation Training

In Brief Simulation training is rapidly becoming an integral element of the education curriculum of anesthesia residency programs. We report a case of successful resuscitation of bupivacaine-induced cardiac arrest treated with IV lipid emulsion by providers who had recently participated in simulation training involving a scenario nearly identical to this case. Upon debriefing, it was determined that the previous training influenced execution of the following steps: rapid problem recognition, prompt initiation of specific therapy in the setting of supportive advanced cardiac life support measures, and coordinated team efforts. Although the true cause of efficient resuscitation and ultimate recovery cannot be proven, the efficiency of the resuscitation process, including timely administration of lipid emulsion, is evidence that simulation may be useful for training providers to manage rare emergencies. IMPLICATIONS: Providers who had recently completed simulation education in the management of local anesthetic cardiac toxicity participated in the successful resuscitation of a patient who suffered cardiac arrest after injection of bupivacaine during a sciatic nerve block. This experience is evidence that simulation training may improve the management of rare emergencies.