899 Administration of Fascia-Iliaca Blocks for Hip Fracture Patients on Admission to the A&E Department at Southport DGH

Aim

Fascia-iliaca block (FIB) is regional anaesthetic used in A&E for hip fractures; they’re performed under landmark guidance in Southport A&E. NICE recommend FIBs for hip fractures if PO/IV paracetamol/opiates provide insufficient relief; it’s shown to provide superior analgesia and reduce opiate consumption. RCEM state FIBs should be administered promptly in A&E by trained personnel and are a listed ACCS competency.

The audit aim was to review the number/percentage of hip fracture patients receiving FIBs, with documentation, in Southport A&E. Hip fracture patients should have documented FIBs, the standard for the audit was ≥90% patients.

Method

This audit was a retrospective analysis of the 6-week period 08/08/2022-20/09/2022 for hip fracture patients at Southport DGH. Data was collected from the National Hip Fracture Database. Patients weren’t delayed to surgery on FIB administration. Online inpatient/A&E notes and drug charts were analysed for FIB documentation.

Results

The sample included 46 patients, 8 male and 38 female. 13 had documented FIBs on admission, 33 had no documented FIB, meaning 28.2% of patients received FIBs in A&E over 6-weeks.

Conclusions

This audit shows too few hip fracture patients are receiving FIBs in Southport A&E as analgesia, with 28.2% documented compared to the desired ≥90% standard. Patients are either not receiving FIBs or not having them documented. FIB use can be improved by clinical audit, and interventions are being implemented to improve use in Southport A&E, including posters, hip fracture proforma additions, and department education.