Author: Sobia Akhtar / Editor: Steve Corry-Bass / Reviewer: Emer Kidney / Codes: PhC1, PhC4, PhP1, RP7, SLO3 / Published: 08/08/2022

A 65-year-old man with a background of osteoarthritis presents to the Emergency Department with left hip pain following a fall. He has pelvic and left hip x-rays which confirm a left neck of femur fracture. A fascia iliaca block with bupivacaine is performed, using the landmark technique. Five minutes later the healthcare assistant approaches you to inform you that they have checked the patient’s observations:

BP: 85/50

HR: 50

SpO2: 97% room air

RR: 9

You proceed to review the patient and note he looks unwell. He is now confused with a GCS of 13 (E4, V4, M5). You transfer the patient to Resus for further assessment and management.

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