{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:07:38Z","timestamp":1779361658116,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":39,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Problem<\/jats:title>\n                    <jats:p>Nerve blocks confer major benefits for patients with hip fractures, but the average time to surgery exceeds the duration of a single injection. We addressed this with an initiative to credential emergency department (ED) doctors and rural generalists to place fascia iliaca block catheters (FIBC), enabling ongoing analgesia until the time of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Cairns and Hinterland Hospital and Health Service, the major referral hospital for Far North Queensland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Measures for Improvement<\/jats:title>\n                    <jats:p>Proportion of hip fracture patients receiving an FIBC in ED or prior to interhospital transfer, time from arrival to block insertion, and complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Strategies for Change<\/jats:title>\n                    <jats:p>Multidisciplinary initiative involving a formal training program and protocol for FIBC insertion, with ongoing follow\u2010up by the acute pain service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Effects of Change<\/jats:title>\n                    <jats:p>\n                      ED doctors now place the majority of FIBC for our hospital, with a median time to block of 4.5\u2009h compared to 13.2\u2009h by anaesthetists (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Over 40% of patients from rural centres receive an FIBC before transfer. Complication rates were low and similar across specialties.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lessons Learnt<\/jats:title>\n                    <jats:p>FIBC insertion in ED and rural hospitals was feasible and safe after a simple training program. Multidisciplinary collaboration was essential to the success of the program.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajr.70124","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T09:34:51Z","timestamp":1765359291000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Emergency Department Fascia Iliaca Block Catheters: A Safe and Feasible Pathway to Hip Fracture Analgesia"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6919-9108","authenticated-orcid":false,"given":"Ruth Miriam","family":"Blank","sequence":"first","affiliation":[{"name":"Anaesthesia &amp; Perioperative Medicine Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastiaan Paul","family":"Blank","sequence":"additional","affiliation":[{"name":"Intensive Care Unit Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phuong","family":"Markman","sequence":"additional","affiliation":[{"name":"Anaesthesia &amp; Perioperative Medicine Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Hardman","sequence":"additional","affiliation":[{"name":"Emergency Department Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Urquhart","sequence":"additional","affiliation":[{"name":"Anaesthesia &amp; Perioperative Medicine Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"},{"name":"James Cook University  Queensland Australia"},{"name":"Lifeflight Cairns, EMQ Hangar Aeroglen  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janna Nathasja","family":"Hazelhoff","sequence":"additional","affiliation":[{"name":"Anaesthesia &amp; Perioperative Medicine Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Stone","sequence":"additional","affiliation":[{"name":"Emergency Department Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Sartain","sequence":"additional","affiliation":[{"name":"Anaesthesia &amp; Perioperative Medicine Cairns and Hinterland Hospital and Health Service  Cairns Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"Australian and New Zealand Hip Fracture Registry \u201cAnnual Report of Hip Fracture Care 2023 \u201d(2023) anzhfr.org\/registry\u2010reports\/."},{"key":"e_1_2_13_3_1","unstructured":"Australian Commission on Safety and Quality in Health Care \u201cHip Fracture Clinical Care Standard. Level 5 255 Elizabeth Street Sydney NSW 2000: Australian Commission on Safety and Quality in Health Care \u201dhttps:\/\/www.safetyandquality.gov.au\/sites\/default\/files\/2023\u201009\/hip\u2010fracture\u2010clinical\u2010care\u2010standard\u20102023.pdf."},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0375-9393.19.13535-3"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001159.pub3"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2021.09.038"},{"issue":"4","key":"e_1_2_13_7_1","first-page":"245","article-title":"Use of Femoral Nerve Blocks to Manage Hip Fracture Pain Among Older Adults in the Emergency Department: A Systematic Review","volume":"18","author":"Riddell M.","year":"2016","journal-title":"Canadian Journal of Emergency"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10195-009-0062-6"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2021.103151"},{"issue":"10","key":"e_1_2_13_10_1","first-page":"866","article-title":"Time to Block: Early Regional Anesthesia Improves Pain Control in Geriatric Hip Fractures","volume":"102","author":"Garlich J. M.","year":"2020","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_13_11_1","unstructured":"Australasian College for Emergency Medicine \u201cAustralasian College for Emergency Medicine Fellowship of the Australasian College for Emergency Medicine Curriculum V4.8 \u201daccessed 31st December 2024 https:\/\/acem.org.au\/getmedia\/9af41df8\u2010677f\u201044ed\u2010b245\u2010440164155f56\/FACEM\u2010Curriculum\u20102021."},{"key":"e_1_2_13_12_1","unstructured":"Australian College of Rural & Remote Medicine \u201cRural Generalist Curriculum \u201d(2021) https:\/\/www.acrrm.org.au\/docs\/default\u2010source\/all\u2010files\/rural\u2010generalist\u2010curriculum.pdf."},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2019.05.001"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019650"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/2047-0525-1-4"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2015.07.004"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.15537\/smj.2019.9.24483"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.11152\/mu\u20103537\/"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.70040"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-019-01362-3"},{"issue":"5","key":"e_1_2_13_21_1","article-title":"Training Emergency Physicians in Ultrasound\u2010Guided Fascia Iliaca Compartment Blocks: Lessons in Change Management","volume":"11","author":"Wilson J.","year":"2019","journal-title":"Cureus"}],"container-title":["Australian Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajr.70124","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ajr.70124","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajr.70124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:49:05Z","timestamp":1779360545000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ajr.70124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/ajr.70124"],"URL":"https:\/\/doi.org\/10.1111\/ajr.70124","archive":["Portico"],"relation":{},"ISSN":["1038-5282","1440-1584"],"issn-type":[{"value":"1038-5282","type":"print"},{"value":"1440-1584","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70124"}}