Rapid Analgesia for Prehospital Hip Disruption (RAPID): a feasibility study for a randomised controlled trial

Breaking a hip is very painful. Patients who break their hip will often call 999 and be taken to hospital by an ambulance.

Sadly, research has shown that paramedics don't always give patients with a broken hip adequate pain relief.

Fascia iliaca compartment block (FICB) has been tested in a few small trials recently. It has been shown to be a safe and effective method of giving pain relief to patients with hip fracture.

FICB involves finding a soft tissue 'compartment' which lies over the hip. This is done using bony landmarks and feeling resistance from a needle. The person giving the FICB will feel two 'pops' as the needle goes through two tissue layers. Local anaesthetic is then injected into this 'compartment' with the aim of blocking sensation to three nerves in this area. The patient will then not be able to feel pain from their hip.

Aim of the research:

We wish to carry out a small study with paramedics giving FICB to patients who break their hip. We think that FICB could give better pain relief to patients who break their hip than what they are given in current practice.

FICB could also reduce the amount of morphine given to patients who break their hip. This would benefit patients because morphine has several side effects (feeling sick, giddy or confused, being constipated or having trouble breathing).

We will also find out whether FICB has any long term benefits by comparing death rates, health status and mobility 30 days after the injury.

We will also find out if it would be possible and worthwhile to carry out a larger trial in a few different areas of the UK.