In light of a recent patient in our ED with a femoral neck fracture…

 

Rather than dose and re-dose opioids, consider an US-guided femoral nerve block for safer, longer, and more effective analgesia [1-3].

 

Courtesy of Robert J. Strony DO, RDMS, RVT via EMdocs.net:

unlabeled femoral region  labeled femoral region

FN: femoral nerve, SFA: superficial femoral artery, DFA: deep femoral artery, FV: femoral vein
(http://www.emdocs.net/ultrasound-guided-femoral-nerve-block/)

femoral nerve block
(video file)

 

References

  1. Beaudoin FL, Nagdev A, Merchant RC, Becker BM. Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures. Am J Emerg Med. 2010 Jan;28(1):76-81.
  2. Haines L, Dickman E, Ayvazyan S, Pearl M, Wu S, Rosenblum D, Likourezos A. Ultrasound-guided fascia iliaca compartment block for hip fractures in the emergency department. J Emerg Med. 2012 Oct;43(4):692-7.
  3. Beaudoin FL, Haran JP, Liebmann O. A comparison of ultrasound-guided three-in-one femoral nerve block versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a randomized controlled trial.Acad Emerg Med. 2013 Jun;20(6):584-91.