Nerve Block: Fascia Iliaca Compartment

Indication

Indicated for isolated femur fractures, etc.

Medications

Use:

1) Ropivacain (Natropin) 0.5%

<20kg = 0.75mL/kg

>20kg = 0.5 ML/kg

^max - 30mL

OR

2) Bupivicaine

^Risk of cardiac depression if injected intravascularly

Procedure

1. Point = 2/3 laterally along line between ant/sup iliac spine and pubis
   1. i.e. sig lateral to nerve
2. 90 deg angle with 22Ga needle
3. 2 "pops" through facial plains (1 inch max)
4. Withdraw to check not in vessel
5. Apply pressure 1 inch caudally accross thigh
6. Infuse drug
7. Hold pressure on thigh for 2 minutes
   1. to encourage cephalad spread

^Should see effect in <10 min

Source

8/07 DONALDSON (adapted from EM Annals 8/07)