RAPID ANALGESIA FOR PREHOSPITAL HIP DISRUPTION (RAPID): A FEASIBILITY STUDY

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Abstract

Background

Adequate pain relief at the point of injury and during transport to hospital is a major challenge in all acute trauma, but especially so for those with hip fractures, whose injuries are difficult to immobilise and who may be particularly sensitive to opiate analgesics. Fascia Iliaca Compartment Block (FICB), a procedure involving injection of local anaesthetic into tissues surrounding the hip, is routinely administered by doctors and nurses in Emergency Departments for patients with hip fracture, but its use has not been tested by paramedics at the scene of the patient's injury.

Aim of the research

This study aims to assess whether FICB administered by paramedics at the scene is feasible, safe and acceptable. The outcome will determined the need for a full randomised controlled trial to decide whether the procedure is effective for patients and worthwhile for the NHS.

Methods

We will recruit ten paramedics in the Swansea locality who will be trained to administer FICB. Eligible patients will be randomly allocated to FICB or usual care using sealed envelopes carried on ambulances, a method currently successfully being used by the Welsh Ambulance Service in another study – PARAMEDIC 2 (the ‘Adrenaline trial’). We will assess compliance of paramedics; pain scores; side effects; length of hospital stay; quality of life; and acceptability to patients and paramedics by conducting interviews and focus groups.

Outputs

We will recommend whether a full randomised controlled trial of FICB by paramedics for hip fracture is warranted and, if so, a proposal for research funding will be submitted.

Outputs

This project is funded by Health and Care Research Wales, through their Research for Patient and Public Benefit funding call (1003). The views and opinions expressed are those of the authors and do not necessarily reflect those of Health and Care Research Wales or the National Health Service.

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