Nerve Blocks for Hip Fractures in the Emergency Department: An Opportunity for Growth

Hip fractures are a common reason for presentation to the emergency department (ED) and are associated with significant morbidity. Nerve blocks have emerged as a safe and effective tool to treat pain associated with hip fractures. In this study, we aimed to measure the frequency with which nerve blocks were performed for ED patients with hip fractures. Our secondary aims were to study the demographic and clinical characteristics of patients who received and did not receive a nerve block.

We performed a retrospective study at a single-center, urban, academic, Level I trauma center. We measured the frequency with which patients received a nerve block. We measured other demographics (age, ethnicity, insurance) and clinical data (comorbidities, Emergency Severity Index, National Emergency Department Overcrowding Scale, and hip fracture type). Lastly, we measured the types of nerve block performed, who performed the nerve block, and any associated complications.

Overall, 17% (36/209) of the studied patients and 14% (36/257) of all patients with an acute hip fracture received a nerve block. Patients who were cared for by ultrasound (US) fellowship-trained physicians were more likely to receive a nerve block compared to patients cared for by non-US fellowship-trained physicians (20/35 vs 16/174; P-value < .001).

Nerve blocks were performed for a minority of patients presenting with an acute hip fracture. Patients who are cared for by ultrasound fellowship-trained physicians may be more likely to receive a nerve block than patients cared for by non-ultrasound fellowship-trained physicians in the emergency department.