A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use

Structured Abstract: Background: Ultrasound-guided nerve blocks (UGNBs) are a vital component of a multimodal approach to managing pain in the Emergency Department (ED). However, implementation has not been universally adopted due to their time-consuming nature and provider discomfort with the proc...

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Main Authors: Joseph R. Brown, Michael Heffler, Peter Alsharif, Brigit Noon, Justin Inman, Eric Bustos, Juliana Wilson, Ryan Tucker
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JEM Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773232025000288
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author Joseph R. Brown
Michael Heffler
Peter Alsharif
Brigit Noon
Justin Inman
Eric Bustos
Juliana Wilson
Ryan Tucker
author_facet Joseph R. Brown
Michael Heffler
Peter Alsharif
Brigit Noon
Justin Inman
Eric Bustos
Juliana Wilson
Ryan Tucker
author_sort Joseph R. Brown
collection DOAJ
description Structured Abstract: Background: Ultrasound-guided nerve blocks (UGNBs) are a vital component of a multimodal approach to managing pain in the Emergency Department (ED). However, implementation has not been universally adopted due to their time-consuming nature and provider discomfort with the procedure. Objectives: The primary outcome of this study was to deploy a new UGNB cart and group of nerve block “champions” and evaluate whether the rate of infrainguinal fascia iliaca compartment block (IFICB) use increased in geriatric hip fractures. Secondary outcomes included length of stay in the ED, complications associated with the UGNB and Morphine Equivalents used compared to patients who did not receive the IFICB. Methods: This was a prospective, observational cohort study performed at a single urban, academic site. Inclusion criteria was based on institutional coding of a hip fracture. Each chart was reviewed as to whether the patient received an IFICIB as well as secondary outcomes like ED length of stay (LOS). Finally, the treating physician was surveyed regarding their decision to perform an IFICB. Results: Of the 146 eligible patients, 15.8 % received an IFICB, an increase from 2.6 % in 2019. 55 physicians were enrolled with a 96 % response rate. Commonly cited reasons for not performing the block were controlled pain and lack of training. Of the 23 UGNBs performed, 14 involved a champion. Despite length of time being cited 10.6 % of the time for not performing the IFICB, patients who received a IFICB had a shorter ED LOS. Conclusion: This study showed that the creation of nerve block “champions” and implementation of an UGNB cart was associated with an increase in their utilization of the IFICB.
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spelling doaj-art-cad02f489fea49dabe84dae444a4a37e2025-08-20T03:31:05ZengElsevierJEM Reports2773-23202025-06-014210016410.1016/j.jemrpt.2025.100164A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block useJoseph R. Brown0Michael Heffler1Peter Alsharif2Brigit Noon3Justin Inman4Eric Bustos5Juliana Wilson6Ryan Tucker7Department of Emergency Medicine, University of Colorado, Aurora, CO, USA; Corresponding author. (708) 372 – 3587, University of Colorado Department of Emergency Medicine, Leprino Building, 7th Floor, Campus Box B215, 12401 E. 17th Avenue, Aurora, CO, 80045, USA.Department of Emergency Medicine, University of Colorado, Aurora, CO, USADepartment of Emergency Medicine, Denver Health and Hospital Authority, Denver, CO, USADepartment of Emergency Medicine, Denver Health and Hospital Authority, Denver, CO, USADepartment of Emergency Medicine, Denver Health and Hospital Authority, Denver, CO, USADepartment of Emergency Medicine, Denver Health and Hospital Authority, Denver, CO, USADepartment of Emergency Medicine, University of Colorado, Aurora, CO, USADepartment of Emergency Medicine, University of Colorado, Aurora, CO, USAStructured Abstract: Background: Ultrasound-guided nerve blocks (UGNBs) are a vital component of a multimodal approach to managing pain in the Emergency Department (ED). However, implementation has not been universally adopted due to their time-consuming nature and provider discomfort with the procedure. Objectives: The primary outcome of this study was to deploy a new UGNB cart and group of nerve block “champions” and evaluate whether the rate of infrainguinal fascia iliaca compartment block (IFICB) use increased in geriatric hip fractures. Secondary outcomes included length of stay in the ED, complications associated with the UGNB and Morphine Equivalents used compared to patients who did not receive the IFICB. Methods: This was a prospective, observational cohort study performed at a single urban, academic site. Inclusion criteria was based on institutional coding of a hip fracture. Each chart was reviewed as to whether the patient received an IFICIB as well as secondary outcomes like ED length of stay (LOS). Finally, the treating physician was surveyed regarding their decision to perform an IFICB. Results: Of the 146 eligible patients, 15.8 % received an IFICB, an increase from 2.6 % in 2019. 55 physicians were enrolled with a 96 % response rate. Commonly cited reasons for not performing the block were controlled pain and lack of training. Of the 23 UGNBs performed, 14 involved a champion. Despite length of time being cited 10.6 % of the time for not performing the IFICB, patients who received a IFICB had a shorter ED LOS. Conclusion: This study showed that the creation of nerve block “champions” and implementation of an UGNB cart was associated with an increase in their utilization of the IFICB.http://www.sciencedirect.com/science/article/pii/S2773232025000288Ultrasound guided nerve blockUltrasound guided proceduresRegional anesthesiaPain managementFascia iliaca compartment blockInfrainguinal fascia iliaca compartment block
spellingShingle Joseph R. Brown
Michael Heffler
Peter Alsharif
Brigit Noon
Justin Inman
Eric Bustos
Juliana Wilson
Ryan Tucker
A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use
JEM Reports
Ultrasound guided nerve block
Ultrasound guided procedures
Regional anesthesia
Pain management
Fascia iliaca compartment block
Infrainguinal fascia iliaca compartment block
title A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use
title_full A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use
title_fullStr A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use
title_full_unstemmed A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use
title_short A nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use
title_sort nerve block supply cart and nerve block champions program associated with increased fascia iliaca block use
topic Ultrasound guided nerve block
Ultrasound guided procedures
Regional anesthesia
Pain management
Fascia iliaca compartment block
Infrainguinal fascia iliaca compartment block
url http://www.sciencedirect.com/science/article/pii/S2773232025000288
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