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WHY ARE ELDERLY PATIENTS WITH HIP FRACTURES LESS OF A PRIORITY THAN WOMEN IN LABOUR WHEN IT COMES TO REGIONAL ANAESTHESIA FOR PAIN CONTROL?
ESRA Academy. Cavalier A. Sep 8, 2016; 138412
Topic: Geriatric Population
Dr. Alison Cavalier
Dr. Alison Cavalier

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Abstract
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Background and Aims:

Anaesthetic trainees at East Surrey Hospital provide a 24 hour service for both labour epidurals in delivery suite and a fascia iliaca block (FIB) service for fractured neck of femur patients (NOF#).
The majority of epidural requests are attended to within one hour, NOF# patients can potentially wait several hours before receiving a FIB.
An anonymous survey was undertaken to gain further insight as to how trainees viewed the needs of a NOF# patient compared with a labouring woman.

Methods:

All anaesthetic trainees with experience in either delivery suite or emergency theatres were surveyed. Questions were related to their opinions on urgency of pain relief in both population groups. As well as how long they felt was reasonable for the patient to wait, and the requirements (including national standards) for each patient group.

Results:

Trainees stated that labour epidurals were more of a clinical priority than FIBs. The rationale for this included the urgency conveyed from the obstetric and midwifery staff. NOF# patients are often reviewed at night and can potentially appear pain free if asleep or not being mobilised.
Very few of the trainees where familiar with NICE guidelines or regional targets for NOF# patients.  

Conclusions:

Anaesthetic trainees had little understanding of the requirements and standards expected for NOF# patients.
Future emphasis and education will be targeted towards realisation that FIBs are a duty of care which is supported by NICE and the RCOA. It is also a matrix by which our hospital is judged and compared to others.

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