Audit of lidocaine use

Area of Science:

• Critical Care Medicine
• Pharmacology
• Clinical Audit

Background:

• Lidocaine is a common antiarrhythmic agent used in critical care settings.
• Ensuring appropriate and effective lidocaine use is crucial for patient outcomes.
• Auditing drug utilization helps identify areas for practice improvement.

Purpose of the Study:

• To audit the use of lidocaine in adult patients within hospital critical-care areas.
• To assess adherence to established criteria for lidocaine administration, efficacy, and toxicity management.
• To identify specific areas of non-compliance and provide recommendations for improvement.

Main Methods:

• A retrospective audit of 50 adult patients receiving lidocaine in critical care.
• Review of medical records using predefined process, outcome, and complication criteria.
• Evaluation of deviations by a physician-led medical audit committee.

Main Results:

• Overall good compliance with lidocaine administration and management criteria was observed.
• Minimal deficiencies noted in initiation (6%), initiation of constant infusion (12%), infusion rate (2%), and oral conversion (2%).
• Substantial deviations occurred when managing recurrent ventricular arrhythmias during lidocaine therapy. No major deficiencies in toxicity management were found.

Conclusions:

• Lidocaine use in critical care generally adheres to established guidelines.
• Specific attention is needed for managing recurrent ventricular arrhythmias during lidocaine therapy.
• The audit provides valuable data for refining lidocaine protocols in critical care settings.