Improving the rate of use of fascia iliaca compartment blocks in patients presenting with hip fractures

US-ST-Fascia Iliaca Block

University of Saskatchewan (ED)

Background/Rationale: Patients presenting to the emergency department (ED) with hip fractures can have their pain controlled through opioid analgesics and/or regional anesthesia. The fascia iliaca compartment block (FICB) has been demonstrated as a safe and easily taught procedure that can have several benefits in these patients that include improved pain scores, reduced rates of delirium and reduced mortality. The FICB is infrequently used in Saskatoon EDs with most physicians relying on opioid analgesics. 

Planned Methodology: Stakeholder engagement and establishment of baseline data will occur over the next several months. Sequential Plan-Do-Study-Act (PDSA) cycles will begin in the fall of 2022 with our first planned cycle as an educational intervention. Outcome measures include: rate of FICBs performed, patient reported pain scale, and rate of opioids used as a primary analgesic modality. Process measures include: time to administration of FICB or opiate analgesics, physician comfort with FICB procedure, and the number of physicians performing FICBs. We will also look at the need for breakthrough analgesia and rate of complications relating to local anesthetics as our balancing measures. 

Expected Results: We expect that at least 50% of patients presenting to Saskatoon EDs with hip fractures will receive the FICB as the primary pain control measure by the end of 2022. Impact Increasing the use of FICBs within our EDs will translate into improved patient comfort and less reliance on opioid analgesics. The reduced use of opioids will directly translate into reduced adverse patient events directly related to the use of these medications.

Sachin Trivedi -

Preliminary data gathering/ baseline