Feature: NCPD ConnectionLocal Anesthetic Systemic Toxicity during Labor, Birth, and Immediate Postpartum Clinical ReviewMock, Nicole D. DNP, CRNA; Griggs, Kellie M. DNP, MSN-Ed, RNC-OB; Mileto, Lisa A. DNP, CRNAAuthor Information Dr. Nicole D. Mock is a Nurse Anesthetist, Department of Anesthesiology, Harnett Health, Dunn, NC. Dr. Mock can be reached via email at [email protected] Dr. Kellie M. Griggs is an Assistant Professor, Department of Academic Nursing, Wake Forest University School of Medicine, Winston-Salem, NC. Dr. Lisa A. Mileto is Director for Doctoral Education, and Assistant Professor, Department of Academic Nursing, Wake Forest University School of Medicine, Winston-Salem, NC. The authors declare no conflicts of interest. For additional Nursing Continuing Professional Development (NCPD) activities related to maternal child nursing, go to nursingcenter.com/ce/mcn MCN, The American Journal of Maternal/Child Nursing: November/December 2021 - Volume 46 - Issue 6 - p 330-338 doi: 10.1097/NMC.0000000000000765 Buy CE Test Metrics AbstractIn Brief Local anesthetic systemic toxicity (LAST) is a life-threatening event caused by elevated local anesthetic plasma concentration. It is often unrecognized or misdiagnosed. Peripartum women are at increased risk for toxicity due to pregnancy-related physiological changes. Rising serum drug levels can cause cellular level impairment of mitochondria and voltage-gated ion channels leading to a cascade of symptoms that can end in cardiac arrest. Local anesthetic systemic toxicity can mimic other maternal pathologies but may be considered if local anesthetics have been used. Published treatment guidelines for this event include lipid emulsion which is approved for use in pregnant women. We review LAST in the maternity care setting, published treatment protocols, management of maternity patients with toxicity, and recommendations to increase awareness among maternity care clinicians for this medical emergency. Local anesthetic systemic toxicity during labor, birth, and postpartum is a medical emergency requiring prompt identification and immediate resposne. A review of the pathophysiology, clinical presentation, and recommended management is provided. Wolters Kluwer Health, Inc. All rights reserved.