“Lignocaine overdose causing toxicity and multiple VF arrests.”

This story serves as a sentinel example of how not to write a critical incident report. It is not stated whether the ‘overdose’ of lignocaine was prescribed and given in a wrong dose or was the right dose given too quickly or whether it was given accidentally. The patient outcome similarly is not reported.

Thus, very little learning follows, but it gives a useful opportunity to remind readers that it is
a stipulation of the College’s Guidelines for the Provision of Anaesthesia Services [1] that “All local anaesthetic solutions should be stored in a separate storage unit from intravenous infusion solutions, to reduce the risk of accidental intravenous administration of such medication” (Chapter 2, point 7.41). Treatment of LA toxicity is detailed in the Association’s QRH [2] or individually on the Association website.[3]

1. Chapter 2: Guidelines for the Provision of Anaesthesia Services for Perioperative Care of Elective and Urgent Care Patients, RCoA, 2023.
2. Quick Reference Handbook, Association of Anaesthetists, 2022.
3. Management of Severe Local Anaesthetic Toxicity, Association of Anaesthetists, 2010.