# Hip Fracture Management Pathways in Older Adults

About This Podcast

Hip fractures are a common injury among older adults and have a staggering one-year mortality of 20-30%. In this episode we discuss a multi-disciplinary pathway to improve the acute care of patients with hip fractures. It can help standardize care, improve pain control, decrease pain-related delirium, reduce the time from the ED to the operating room, and decrease the hospital length of stay. Also, if you have never heard of the fascia iliaca compartment block for pain management in patients with hip fractures, this could be practice-changing for you!

Play the Episode

https://youtu.be/UZrBEpu4tp4

Resources

Femoral Nerve Block podcast from the ultrasound podcast.

Fascia Iliaca block Video

Femoral Nerve Block video

Description of guidelines from the UK on recommendations for hip fracture management.

Next, listen to Dangerous Med Combos in Older Adults with David Juurlink and Bryan Hayes.

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References

Tinetti ME, Inouye SK, Gill TM, et al. Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes. JAMA 1995;273(3):1348–1353. PMID 7715059

Godoy Monzon, D., et al. (2007). “Single fascia iliaca compartment block for post-hip fracture pain relief.” Journal of Emergency Medicine 32(3): 257-262. PMID 17394987

Gottschalk, A., et al. (2015). “The Impact of Incident Postoperative Delirium on Survival of Elderly Patients After Surgery for Hip Fracture Repair.” Anesthesia and Analgesia. PMID 25590791

Hogh, A., et al. (2008). “Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture.” Strategies Trauma Limb Reconstr 3(2): 65-70. PMID 18762870

Kates, S. L., et al. (2015). “Financial Implications of Hospital Readmission After Hip Fracture.” Geriatr Orthop Surg Rehabil 6(3): 140-146. PMID 26328226 http://www.ncbi.nlm.nih.gov/pubmed/26328226

Lees, D., et al. (2014). “Fascia iliaca compartment block for hip fractures: experience of integrating a new protocol across two hospital sites.” European Journal of Emergency Medicine. PMID 24949565

Marcantonio, E. R., et al. (2000). “Delirium is independently associated with poor functional recovery after hip fracture.” Journal of the American Geriatrics Society 48(6): 618-624. PMID 10855596

Mouzopoulos, G., et al. (2009). “Fascia iliaca block prophylaxis for hip fracture patients at risk for delirium: a randomized placebo-controlled study.” Journal of Orthopaedics and Traumatology 10(3): 127-133. PMID: 19690943

Mundi, S., et al. (2014). “Similar mortality rates in hip fracture patients over the past 31 years.” Acta Orthopaedica 85(1): 54-59. PMID 24397744

Stoneham, M., et al. (2014). “Emergency surgery: the big three–abdominal aortic aneurysm, laparotomy and hip fracture.” Anaesthesia 69 Suppl 1: 70-80. PMID 24303863

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