Original Publication
Open Access

Simulation Scenario: Local Anesthetic Toxicity During Placement of Regional Nerve Block

Published: July 29, 2009 | 10.15766/mep_2374-8265.3161

Included in this publication:

  • Local Anesthetic Toxicity.doc
  • Resource Sample 1.doc
  • Resource Sample 2.doc
  • Resource Sample 3.doc
  • Resource Sample 4.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


This resource is a simulator scenario where local anesthetic toxicity develops after placement of a regional nerve block. The goal of this scenario is to teach medical students, residents, nurses, and other health professionals about the systemic effects of local anesthetic toxicity, as well as to teach team building during medical crisis. Local anesthetic toxicity is uncommon but potentially deadly. Because it is a rare occurrence, learners are oftentimes unexposed to it during training. This scenario is designed to teach about recognition and treatment of this problem in a safe environment. The scenario was modified after trial runs at our institution showed that too much emphasis was being placed on how to do the block. The scenario can be modified by users to match the level of trainee by stopping the scenario at mild, moderate, or severe toxicity. The scenario can also be modified for novice users by having the block in place and just injecting the drug into the catheter, thereby eliminating the need to know how to place the block.

Educational Objectives

By the end of this simulation, learners should be able to:

  1. Identify the signs and symptoms of local anesthetic toxicity in an unanesthetized patient.
  2. Provide treatment for local anesthetic toxicity.
  3. Understand the risk factors for development of local anesthetic toxicity.
  4. Develop communication skills necessary for leading a team through a medical crisis.
  5. Discuss methods to reduce the incidence of this type of error.

Author Information

  • Christina Spofford, MD, PhD: University of Iowa Roy J. and Lucille A. Carver College of Medicine

None to report.

None to report.


Spofford C. Simulation scenario: local anesthetic toxicity during placement of regional nerve block. MedEdPORTAL. 2009;5:3161. https://doi.org/10.15766/mep_2374-8265.3161