Fascia iliaca compartment block versus IV morphine for femoral fracture pain
Jonathan Williams
Tuesday, April 2, 2019
Background:
Femoral trauma in the UK is increasing. The fascia iliaca compartment block (FICB) could be a more effective, safer way to ease pain and distress from femoral trauma in the prehospital environment than the current practice of intravenous morphine.
Aim:
To conduct a systematic review to accumulate evidence concerning prehospital FICB for patients with femoral fracture.
Methodology:
A systematic review was conducted using the CINAHL, Medline, AMED, PubMed and Embase databases. In addition, a hand search of the Journal of Paramedic Practice and the Australasian Journal of Paramedicine was performed. The search was carried out from 28 March–24 April 2018.
Results:
Twenty-eight papers were sourced by the methodology, of which four met the inclusion criteria and were subsequently analysed.
Conclusion:
This review shows that prehospital FICB can be efficacious in a number of prehospital environments and is feasible for a variety of patients with a range of femoral fractures. Additionally, FICB has limited reported adverse side effects in the prehospital environment and would appear to be safe. However, evidence comparing the efficacy of a prehospital FICB to intravenous morphine use for pain management in femoral fractures is limited. This review indicates that more research in this area would be beneficial.
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