Medical School, Swansea University, Swansea, UK.
Public contributor, c/o Swansea University, Swansea, UK.
BMJ Open. 2019 Feb 15;9(2):e026073. doi: 10.1136/bmjopen-2018-026073.
To explore paramedics' experience of delivering fascia iliaca compartment block FICB) to patients with suspected hip fracture at the scene of injury.
Focus groups within a randomised controlled trial.
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.
11 paramedics.
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.
Paramedics' experiences of administering FICB gathered through thematic analysis of interview transcripts by two researchers, one paramedic and one lay member.
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.
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.
ISRCTN60065373; Pre results.
探索护理人员在现场对疑似髋部骨折患者进行闭孔筋膜室综合征阻滞（FICB）的体验。
随机对照试验中的焦点小组。
南威尔士某急诊科服务区内的救护站，参与了一项关于替代常规院前髋部骨折患者疼痛管理的可行性研究，在该研究中接受招募和培训的护理人员。
11 名护理人员。
对疑似髋部骨折的患者进行护理人员管理的 FICB。我们使用经审核的刮刮卡，将符合条件的患者随机分配到 FICB 组（直接向髋部区域注射局部麻醉剂）或常规护理组（最常见的是吗啡）。
通过两位研究人员、一位护理人员和一位非专业人员对访谈记录进行主题分析，收集护理人员实施 FICB 的经验。
受访者认为 FICB 是护理人员实施的合适干预措施。它符合常规实践，并且在人们的能力范围内。他们表示，与常规护理相比，准备和实施 FICB 最多需要多花费 10 分钟，部分原因是紧张和对新程序不熟悉。他们赞扬了所提供的培训，但表示担心因注射到错误的位置而造成伤害。在一个护理人员团队成功治疗一例局部麻醉中毒患者后，信心有所增强。报告的挑战与紧急情况有关：患者通常需要等待数小时才能等来救护车；移动患者会加重他们的疼痛；当护理人员实施治疗时，家属和邻居在场。
护理人员愿意并能够在将疑似髋部骨折患者送往医院之前进行 FICB。可行性研究的结果将为进一步的研究提供信息。
ISRCTN60065373；预注册结果。
