SafeLocal

SafeLocal is an application developed by Johns Hopkins that makes calculating safe dosages of local anesthetic quick and easy for anesthesiologists, surgeons, and other medical providers. It seamlessly incorporates patient weight, disease processes, mixtures of local anesthetic, and presence or absence of additives, to calculate the maximum safe dose of local anesthetic without the hassle of going through the calculations by hand, all while tracking how much of the maximum safe dose has been used up and how much is left over for safe administration.

FEATURES:

● Dosage calculator for local anesthetics, including complex mixtures and non-standard concentrations.

● Adjusts maximum safe dose by patient weight (lbs or kg).

● Choice between anesthesia with or without epinephrine.

● Option to add comorbidities such as extremes of age, severe renal dysfunction, hepatic dysfunction, or advanced heart failure, with automatic adjustment of maximum safe dose.

● Ability to calculate remaining safe dose of anesthesia for anesthesiologist or surgeon to administer based on how much has already been administered.

Calculations based on Chapter 36 (Local Anesthesia) of Miller’s Anesthesia, 8th Edition. Adjustment for comorbidities based on the 2004 publication “Maximum Recommended Doses of Local Anesthetics: A Multifactorial Concept” by Rosenberg et al.

The information provided by the application is based on expert opinion. It is to be used as a recommendation only. Clinical judgment by a physician is required in every situation. The user assumes all responsibility for decisions made with the information provided by this app.

Project produced at the Johns Hopkins University School of Medicine by Jonathan D. Lin, M.D. and Jean-Pierre P. Ouanes, D.O. Funded generously by the Johns Hopkins Bayview Patient Safety Pyramid Grant Program.

Checklist for local anesthetic systemic toxicity adapted from the 2017 version of the American Society of Regional Anesthesia and Pain Medicine Checklist for Managing Local Anesthetic Systemic Toxicity. Source: Neal JM, Woodward CM, Harrison TK. The American Society of Regional Anesthesia and Pain Medicine Checklist for Managing Local Anesthetic Systemic Toxicity: 2017 Version. Reg Anesth Pain Med. 2018 Feb;43(2):150-153.