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RCEM Fascia Iliaca Block (FICB) guideline

The Royal College of Emergency Medicine has recently published a Best Practice Guideline1 on the use of fascia iliaca blocks (FIB) in the ED. Whilst national guidance is always welcome in helping to ensure consistent care and change practice for the better, there are a number of parts of this guidance that differ from our normal practice and what we teach. There are also some areas the guideline ignores altogether. In this post we aim to explain why we disagree with some areas of the guideline and fill in some of the gaps. Who should get a block? We are of the opinion that fascia iliaca blocks should form a standard part of the management of pretty much anyone with a fracture of the hip or femur. It may well not totally replace the need for other forms of analgesia but it is a key tool in providing good pain…

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