Fascia Iliaca compartment block: A nurse-led initiative for preoperative pain management in patients with a fractured neck of femur
Editor’s comments: This is an example of extending the field of practice of the orthopaedic nurse. The result is a quicker and more effective intervention for pain relief. However, in developing similar areas of practice the question should always be asked about why the nurse is taking it on. If it is to ease other professionals’ workloads then caution should be taken, as the prime reason should be that the nurse is the most appropriate and effective person to carry out the intervention.
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Summary
This audit investigated a nurse-led service delivering effective preoperative pain relief for patients with a fractured neck of femur. The fascia iliaca compartment block has a greater margin of safety than a femoral block as the needle is inserted at a distance lateral to the femoral neurovascular bundle; therefore, nurses can potentially be trained to perform it. Pain Nurses were trained in patient selection, consent, performing the block and the management of possible complications. Pain scores were assessed before and after the block and afterwards at 15min, 2, 8 and 24h. There were no complications recorded and post-block opioid requirements were reduced.
The audit showed that a fascia iliaca block provided pain relief in more than 70% of cases. It demonstrated that non-anaesthetic personnel can perform the block successfully and provide the service more readily, resulting in more patients receiving improved pain management.
Keywords: Fascia iliaca compartment block, Nurse-led, Preoperative pain, Fractured neck of femur, Audit
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PII: S1361-3111(08)00042-3
doi:10.1016/j.joon.2008.07.007
© 2008 Published by Elsevier Inc.
