Fascia Iliaca (FICB) block in the emergency department for adults with neck of femur fractures: A review of the literature

• A wide range of papers were reviewed.
• Fascia Iliaca block (FICB) is effective in providing analgesia for proximal femoral fractures.
• FICB has less systemic side effects that opiates.
• Non-medical practitioners are able to administer FICB.

ObjectiveTo ascertain the efficacy of fascia iliaca block for providing analgesia for adults with proximal femoral fractures when compared with standard management. The potential for non-medical practitioners to deliver this block was also assessed.MethodMedline and CINAHL were searched, as were the reference lists from located articles. The title was reviewed and eligibility determined by this and abstract. The full text was then reviewed. A wide range of papers were included. The Cochrane library was also searched as were case reports.Results179 papers were identified, of which 12 were included for review after eligibility sorting and removal of duplicates. These comprised 2 randomised control trials, an audit, a literature review, 5 cohort studies, NICE guidelines and an interventional uncontrolled trial. The Cochrane library revealed no studies that met the search criteria. 2 case reports detailing adverse outcomes were identified. All papers showed FICB to have a similar or greater efficacy to systemic treatment, with fewer adverse side effects.ConclusionsFICB is an effective method of providing analgesia in these patients without the undesirable side effects of systemic opioids. Non- medical practitioners are capable of administering this block.