1622 - Local Anesthetic Systemic Toxicity (LAST): An Effort to Close Knowledge Gaps Among Physical Medicine and Rehabilitation (PM&R) Physicians

PM&R residents completed a pre-intervention survey assessing subjective confidence and objective knowledge of LAST, participated in a 20-minute educational session, and then repeated the survey post-intervention. There is also a follow-up survey planned at three months to assess for knowledge retention. In addition, PM&R attending physicians completed the pre-intervention survey alone without the educational session.

Results:

The primary outcomes are the confidence and knowledge of PM&R physicians in the awareness, identification, and management of patients with LAST. Confidence was measured with a Likert Scale. Twenty-eight PM&R participants (27 residents, 1 attending) completed both pre- and post-intervention surveys and 7 PM&R attending physicians completed the pre-survey. Confidence was improved in all 7 domains tested (p value=0.0001). Of all participants (n=35), 89% agreed/strongly agreed that it is important for all PM&R residents to learn about LAST, 80% disagreed/strongly disagreed to being previously exposed to formal LAST education and 71% agreed/strongly agreed that they intend to use/use local anesthetics in their future/current practices. Average score out of 6 objective questions for participants who attended the educational session was 2.50 pre-intervention and 5.21 post-intervention (p=0.0001), whereas attending physicians who did not attend the educational session scored an average of 3.43 out of 6 total questions.

Conclusions: This study redemonstrates prior findings of significant knowledge gaps of LAST among PM&R physicians at all levels, but demonstrates that a brief educational session can improve both confidence and objective knowledge on this subject. Given these findings, the integration of LAST education should be considered as part of the PM&R core curriculum.