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Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups

Bridie Evans Orcid Logo, Ashra Khanom Orcid Logo, Bridie Angela Evans, Alan Brown, Jenna Bulger, Greg Fegan, Simon Ford, Katy Guy, SIan Jones, Leigh Keen, Ashrafunnesa Khanom, Mirella Longo, Ian Pallister, Nigel Rees, Ian T Russell, Anne C Seagrove, Alan Watkins Orcid Logo, Helen Snooks Orcid Logo

BMJ Open, Volume: 9, Issue: 2, Start page: e026073

Swansea University Authors: Bridie Evans Orcid Logo, Ashra Khanom Orcid Logo, Greg Fegan, Alan Watkins Orcid Logo, Helen Snooks Orcid Logo

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DOI (Published version): 10.1136/bmjopen-2018-026073

Abstract

Objectives To explore paramedics’ experience of delivering fascia iliaca compartment block (FICB) to patients with suspected hip fracture at the scene of injury.Design Focus groups within a randomised controlled trial.Setting Paramedics based at ambulance stations in the catchment area of one Emerge...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: 2019
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We randomly allocated eligible patients to FICB, a local anaesthetic injection directly into the hip region&#x2014;or usual care, most commonly morphine - using audited scratch cards.Outcomes Paramedics&#x2019; experiences of administering FICB gathered through thematic analysis of interview transcripts by two researchers, one paramedic and one lay member.Results Respondents believed that FICB was a suitable intervention for paramedics to deliver. It aligned with routine practice and was within people&#x2019;s capabilities. They said it took up to 10&#x2009;minutes longer than usual care to prepare and deliver, in part due to nervousness and unfamiliarity with a new procedure. They praised the training provided but said they were anxious about causing harm by injecting into the wrong location. Confidence increased after one paramedic team successfully treated a patient for local anaesthetic toxicity. Reported challenges related to the emergency context: patients often waited many hours for ambulance arrival; moving patients exacerbated their pain; family and neighbours were present as paramedics administered treatment.Conclusions Paramedics are willing and able to administer FICB to patients with suspected hip fracture before ambulance transport to hospital. 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spelling 2020-11-23T15:58:42.8846821 v2 51184 2019-07-25 Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups 6098eddc58e31ac2f3e070cb839faa6a 0000-0003-0293-0888 Bridie Evans Bridie Evans true false 1f0f14742e3a36e8fd6d29f59374a009 0000-0002-5735-6601 Ashra Khanom Ashra Khanom true false a9005418b89918776f3d8895ba42e850 Greg Fegan Greg Fegan true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 2019-07-25 HDAT Objectives To explore paramedics’ experience of delivering fascia iliaca compartment block (FICB) to patients with suspected hip fracture at the scene of injury.Design Focus groups within a randomised controlled trial.Setting Paramedics based at ambulance stations in the catchment area of one Emergency Department in South Wales, recruited and trained in a feasibility study about an alternative to routine prehospital pain management for patients with suspected hip fracture.Participants 11 paramedics.Intervention Paramedic-administered FICB to patients with suspected hip fracture. We randomly allocated eligible patients to FICB, a local anaesthetic injection directly into the hip region—or usual care, most commonly morphine - using audited scratch cards.Outcomes Paramedics’ experiences of administering FICB gathered through thematic analysis of interview transcripts by two researchers, one paramedic and one lay member.Results Respondents believed that FICB was a suitable intervention for paramedics to deliver. It aligned with routine practice and was within people’s capabilities. They said it took up to 10 minutes longer than usual care to prepare and deliver, in part due to nervousness and unfamiliarity with a new procedure. They praised the training provided but said they were anxious about causing harm by injecting into the wrong location. Confidence increased after one paramedic team successfully treated a patient for local anaesthetic toxicity. Reported challenges related to the emergency context: patients often waited many hours for ambulance arrival; moving patients exacerbated their pain; family and neighbours were present as paramedics administered treatment.Conclusions Paramedics are willing and able to administer FICB to patients with suspected hip fracture before ambulance transport to hospital. Feasibility study findings will inform further research. Journal Article BMJ Open 9 2 e026073 2044-6055 2044-6055 15 2 2019 2019-02-15 10.1136/bmjopen-2018-026073 COLLEGE NANME Health Data Science COLLEGE CODE HDAT Swansea University 2020-11-23T15:58:42.8846821 2019-07-25T13:47:09.0087394 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Bridie Evans 0000-0003-0293-0888 1 Ashra Khanom 0000-0002-5735-6601 2 Bridie Angela Evans 3 Alan Brown 4 Jenna Bulger 5 Greg Fegan 6 Simon Ford 7 Katy Guy 8 SIan Jones 9 Leigh Keen 10 Ashrafunnesa Khanom 11 Mirella Longo 12 Ian Pallister 13 Nigel Rees 14 Ian T Russell 15 Anne C Seagrove 16 Alan Watkins 0000-0003-3804-1943 17 Helen Snooks 0000-0003-0173-8843 18 0051184-09082019140406.pdf 51184.pdf 2019-08-09T14:04:06.9200000 Output 298058 application/pdf Version of Record true 2019-08-08T00:00:00.0000000 Released under the terms of a Creative Commons Attribution Non Commercial (CC-BY-NC) license. true eng
title Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups
spellingShingle Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups
Bridie Evans
Ashra Khanom
Greg Fegan
Alan Watkins
Helen Snooks
title_short Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups
title_full Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups
title_fullStr Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups
title_full_unstemmed Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups
title_sort Paramedics’ experiences of administering fascia iliaca compartment block to patients in South Wales with suspected hip fracture at the scene of injury: results of focus groups
author_id_str_mv 6098eddc58e31ac2f3e070cb839faa6a
1f0f14742e3a36e8fd6d29f59374a009
a9005418b89918776f3d8895ba42e850
81fc05c9333d9df41b041157437bcc2f
ab23c5e0111b88427a155a1f495861d9
author_id_fullname_str_mv 6098eddc58e31ac2f3e070cb839faa6a_***_Bridie Evans
1f0f14742e3a36e8fd6d29f59374a009_***_Ashra Khanom
a9005418b89918776f3d8895ba42e850_***_Greg Fegan
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
author Bridie Evans
Ashra Khanom
Greg Fegan
Alan Watkins
Helen Snooks
author2 Bridie Evans
Ashra Khanom
Bridie Angela Evans
Alan Brown
Jenna Bulger
Greg Fegan
Simon Ford
Katy Guy
SIan Jones
Leigh Keen
Ashrafunnesa Khanom
Mirella Longo
Ian Pallister
Nigel Rees
Ian T Russell
Anne C Seagrove
Alan Watkins
Helen Snooks
format Journal article
container_title BMJ Open
container_volume 9
container_issue 2
container_start_page e026073
publishDate 2019
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2018-026073
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description Objectives To explore paramedics’ experience of delivering fascia iliaca compartment block (FICB) to patients with suspected hip fracture at the scene of injury.Design Focus groups within a randomised controlled trial.Setting Paramedics based at ambulance stations in the catchment area of one Emergency Department in South Wales, recruited and trained in a feasibility study about an alternative to routine prehospital pain management for patients with suspected hip fracture.Participants 11 paramedics.Intervention Paramedic-administered FICB to patients with suspected hip fracture. We randomly allocated eligible patients to FICB, a local anaesthetic injection directly into the hip region—or usual care, most commonly morphine - using audited scratch cards.Outcomes Paramedics’ experiences of administering FICB gathered through thematic analysis of interview transcripts by two researchers, one paramedic and one lay member.Results Respondents believed that FICB was a suitable intervention for paramedics to deliver. It aligned with routine practice and was within people’s capabilities. They said it took up to 10 minutes longer than usual care to prepare and deliver, in part due to nervousness and unfamiliarity with a new procedure. They praised the training provided but said they were anxious about causing harm by injecting into the wrong location. Confidence increased after one paramedic team successfully treated a patient for local anaesthetic toxicity. Reported challenges related to the emergency context: patients often waited many hours for ambulance arrival; moving patients exacerbated their pain; family and neighbours were present as paramedics administered treatment.Conclusions Paramedics are willing and able to administer FICB to patients with suspected hip fracture before ambulance transport to hospital. Feasibility study findings will inform further research.
published_date 2019-02-15T04:02:58Z
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