CodeBlue
Drug Reference

Antidotes

IV lipid emulsion (20%)

Also: Intralipid, ILE

Lipid sink / metabolic rescue

LAST / rescueAdult> 70 kg: 100 mL bolus over 2–3 min then 200–250 mL over 15–20 min. ≤ 70 kg: 1.5 mL/kg bolus then 0.25 mL/kg/minPeds1.5 mL/kg bolus, 0.25 mL/kg/min

Indications

  • Local anesthetic systemic toxicity (LAST)
  • Refractory lipophilic drug toxicity (bupivacaine, TCA, CCB, BB)

Contraindications & cautions

  • Egg/soy allergy (relative)

Key pearls

  • Max ≈ 12 mL/kg in the first 30 min
  • In LAST arrest: reduce epinephrine to ≤ 1 mcg/kg doses
  • Interferes with lab assays