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In 2010-11 approximately 968 hip fracture patients presented to emergency departments in the Greater Toronto Local Health Integration Network (GTA-LHIN). Optimal pain management is a frequently overlooked aspect of hip fracture patient care, which may contribute to patient outcomes. Although recommendations have been published, there is currently not a standardized approach to the analgesic management of pain in the hip fracture patient. Nerve blocks, including the fascia iliaca compartment block (FICB), are more effective than traditional opioid analgesics in reducing pain after hip fracture. Research suggests that analgesia via nerve blockade is best initiated early, upon arrival to the emergency department. Emergency physicians are trained in ultrasound, and do utilize regional anaesthesia; however, the frequency of block utilization and techniques used for block insertion are unknown. We sought to undertake the first survey of Emergency Department (ED) staff and resident physicians across the GTA-LHIN, looking at the current ED practice of nerve block analgesia in hip fracture patients.

Survey of Current Practices: Peripheral Nerve Block Utilization by ED Physicians for Treatment of Pain in the Hip Fracture Patient Population