The most common indication for fascia iliaca block in the emergency department is for a fractured neck of femur. It is now considered a part of the standard of care for this patient cohort.
NICE recommends that paracetamol should routinely be prescribed for these patients, along with judicious use of opiates8. Nerve blocks should be considered as an adjunct if preoperative pain relief is inadequate, or if opiates need to be limited for clinical reasons. Nerve blocks should never be considered a substitute for early surgery.
Nerve blocks should be administered by trained personnel. This could include nurse practitioners or paramedics in addition to physician practitioners9,10.
Absolute contraindications:
Relative contra-indications
Anticoagulation (this is no longer an absolute contraindication, and with training and ultrasound guidance, nerve blocks can be considered for all anticoagulated patients)11.