Anatomy for Emergency Medicine 028: Fascia Iliaca Block

Hi Guys, sorry for the big gap in posting.

Life has a way of taking over as you all know.

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I’m currently trying to introduce fascia iliaca blocks as part of routine care for patients in our department so i thought a podcast on some of the anatomy wouldn’t go a miss. If you want some light reading on the literature, then I’ve included a big list below.

If you’re more practically orientated then I’d strongly recommend the following:

Ultrasound Podcast: Fem Nv Block

NYSORA: Fascia Iliaca Block.

 

References:

Gray’s Anatomy 41st Edition

1.Godoy Monzón D, Vazquez J, Jauregui JR, Iserson KV. Pain treatment in post-traumatic hip fracture in the elderly: regional block vs. systemic non-steroidal analgesics. Int J Emerg Med. 2010;3(4):321–5.

2.Mouzopoulos G, Vasiliadis G, Lasanianos N, Nikolaras G, Morakis E, Kaminaris M. Fascia iliaca block prophylaxis for hip fracture patients at risk for delirium: a randomized placebo-controlled study. J Orthopaed Traumatol. 2009 Aug 19;10(3):127–33.

3.Høgh A, Dremstrup L, Jensen SS, Lindholt J. Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture. Strat Traum Limb Recon. 2008 Sep 2;3(2):65–70.

4.Godoy Monzón D, Iserson KV, Vazquez JA. Single fascia iliaca compartment block for post-hip fracture pain relief. JEM. 2007 Apr;32(3):257–62.

5.NZ Guidelines Group. Acute Management and Immediate Rehabilitation After Hip Fracture Amongst People Aged 65 Years and Over. 2003;:1–40.

6.National Clinical Guideline Centre. The management of hip fracture in adults. 2011;:1–664.

7.SIGN SIGN. Management of hip fracture in older people. 2009 Jun;:1–56.

8.(null) INHFDSG. Irish Hip Fracture Database Preliminary Report 2013. 2014 Mar 4;:1–50.

9.(null) TCOEM. Clinical Standards for Emergency Departments. 2013;:1–16.

10.Beaudoin FL, Haran JP, Liebmann O. A Comparison of Ultrasound-guided Three-in-one Femoral Nerve Block Versus Parenteral Opioids Alone for Analgesia in Emergency Department Patients With Hip Fractures: A Randomized Controlled Trial. Academic Emergency Medicine. 2013 Jun 12;20(6):584–91.

11.Elkhodair S, Mortazavi J, Chester A, Pereira M. Single fascia iliaca compartment block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study. Eur J Emerg Med. 2011 Dec;18(6):340–3.

12.Williams R, Saha B. Best evidence topic report. Ultrasound placement of needle in three-in-one nerve block. Emergency Medicine Journal. 2006 May;23(5):401–3.

13.Christos SC, Chiampas G, Offman R, Rifenburg R. Ultrasound-guided three-in-one nerve block for femur fractures. West J Emerg Med. 2010 Sep;11(4):310–3.

14.Fletcher AK, Rigby AS, Heyes FLP. Three-in-one femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized, controlled trial. Ann Emerg Med. 2003 Feb 1;41(2):227–33.

15.Beaudoin FL, Nagdev A, Merchant RC, Becker BM. Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures. Am J Emerg Med. 2010 Jan;28(1):76–81.

16.Haines L, Dickman E, Ayvazyan S, Pearl M, Wu S, Rosenblum D, et al. Ultrasound-guided fascia iliaca compartment block for hip fractures in the emergency department. JEM. 2012 Oct;43(4):692–7.

17.Rashid A, Beswick E, Galitzine S, Fitton L. Regional analgesia in the emergency department for hip fractures: survey of current UK practice and its impact on services in a teaching hospital. Emergency Medicine Journal. 2013 Jul 22.

18.Abou-Setta AM, Beaupre LA, Rashiq S, Dryden DM, Hamm MP, Sadowski CA, et al. Comparative effectiveness of pain management interventions for hip fracture: a systematic review. Ann Intern Med. 2011 Aug 16;155(4):234–45.

19.Parker MJ, Griffiths R, Appadu BN. Nerve blocks (subcostal, lateral cutaneous, femoral, triple, psoas) for hip fractures. Cochrane Database Syst Rev. Wiley Online Library; 2002;1.

20.Foss NB, Kristensen BB, Bundgaard M, Bak M, Heiring C, Virkelyst C, et al. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiology. 2007 Apr;106(4):773–8.

About Andy Neill

EM Reg/Resident based near Dublin. Former anatomy lecturer, theology student and occasional musician @andyneill | + Andy Neill | Contact

Comments

  1. Cian McDermott says:

    Hi Andy -- good podcast thanks. Have been reading FN blocks v FI compartment blocks recently. Both very useful and no #NOF or femur leaves our ED without either block. It would be great to make sure that the same standard of care applies in Irish EDs.
    2 useful papers
    /Users/Cian/Google Drive/FOAM/FN block/FasciaIliaca.pdf
    /Users/Cian/Google Drive/FOAM/FN block/Nic Reid FNB.pdf

  2. Hey Andy,
    Joel Turner sent us your link. Great podcast! Very useful. We have a bit more info on our blog Greg Hall and I have a couple of posts regarding a system issues and a kit for femoral nerve blocks.
    System issues: http://edeblog.com/2014/05/yes-yes-you-do-have-time-to-do-pocus/
    Kit: http://edeblog.com/2013/11/femoral-nerve-block-gear/
    Steve

    • Hi Steve. I actually found your site just recently. I’m a big fan of programmed kits for things like this. Unfortunately we haven’t got beyond kits for foley catheters yet!

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