Latent Threats Identified During In Situ Simulated Local Anesthetic Systemic Toxicity Crises in the Operating Room: Implications for System Safety
Authors' conclusion
The findings highlight that improving LAST crisis response requires more than clinician education.
Study context
- Population
- OR staff (anesthesiologists, nurses, anesthesia assistants) in in situ simulated Local Anesthetic Systemic Toxicity (LAST) crises8 simulations
- Participants
- 38 participants
- Outcome
- Latent safety threats (LSTs) across all phases of LAST response, by clinical phase and SEIPS system factor
Methodological detailsvideo analysis, inductive coding, modified SEIPS framework, Staff: 15 anesthesiologists, 16 nurses, 7 anesthesia assistants
- Video analysis
- Inductive coding
- Modified SEIPS framework
- Staff: 15 anesthesiologists, 16 nurses, 7 anesthesia assistants
Main finding
As reported in the abstract
LSTs identified
- Total latent safety threats (LSTs)
- 183
- LST frequency varied by clinical phase
- P < .001
- During Management after diagnosis
- 90/183; 49%
- Environment
- 55/183; 30.1%
- Organization
- 54/183; 29.5%
- Tasks
- 38/183; 21.3%
- Poor Physical Layout
- 43/183; 23.5%
- Role Allocation Deficiencies
- 42/183; 23%
Original publication
Latent Threats Identified During In Situ Simulated Local Anesthetic Systemic Toxicity Crises in the Operating Room: Implications for System Safety. Anesth Analg. Published 16 February 2026. doi:10.
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