Summary
Randomised trial of clinical and cost effectiveness of Administration of Prehospital fascia Iliaca compartment block (FICB) for emergency hip fracture care Delivery.
Funder: NIHR Health Technology Assessment
Background
Hip fractures are a very common injury for elderly people. About one in three patients who break their hip die within one year and many patients lose mobility and independence. Pain relief before the patient reaches hospital is often inadequate and causes side effects which may slow down recovery. We have recently completed a small study testing whether a local anaesthetic injection into the hip area called Fascia Iliaca Compartment Block (FICB) given by paramedics at the scene of injury is safe and acceptable. We met all the criteria that we set at the beginning of the study, and concluded that it is feasible to undertake a full trial.
Aim
We aim to find out whether the local anaesthetic injection reduces pain, is safe, and improves patient health outcomes, as well as how much it costs the National Health Service (NHS).
Who can participate?
Adult patients attended by a participating study paramedic following a 999 call who are assessed as having an isolated hip fracture.
What does the study involve?
We will carry out a trial where paramedics give patients either the new treatment – local anaesthetic injection or usual care (often morphine). 1,400 patients will be randomly allocated to one or other treatment. We will provide training for the paramedics who take part in the trial, so that they can perform the local anaesthetic injection safely. When a trained paramedic attends a patient he or she assesses as having a hip fracture, (s)he will use a scratch card to decide which treatment to give the patient. We will compare patients’ pain levels, other outcomes and costs between those allocated to the new local anaesthetic injection and those allocated to receive usual care. The other outcomes we will compare between the two groups during their initial care and up to four months following injury are: length of stay in hospital, deaths, quality of life, ability to walk, and satisfaction with care. We will also monitor safety by identifying any concerning health-related events in each group. We will work out the costs of NHS care in each group.
You can find further information on RAPID 2 here
Contact Details
Trial Manager / Lead Contact: Dr Mark Kingston
Phone: 01792 606844
Email: m.r.kingston@swansea.ac.uk
ISCRTN Number: 15831813; IRAS ID: 291853;