{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:48:16Z","timestamp":1782406096849,"version":"3.54.5"},"reference-count":23,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"unspecified","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,5,29]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to describe the knowledge, attitudes and practices of emergency department (ED) doctors regarding regional analgesia (RA) for hip fractures and to compare these across levels of experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A prospective, multicentre survey-based cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Surveys were collected at the EDs of three university-affiliated hospitals in Johannesburg, South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>80 surveys were collected. Participants included all ED doctors. Doctors completing their internship years were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>The primary objectives of this study were to describe the knowledge, attitudes and practices of participants regarding the use of RA in hip fractures in the ED; to compare these across different levels of experience based on age, rank and number of years working in the ED; to describe perceived barriers to its use and to describe the frequency of RA use for hip fracture among participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty-nine per cent of respondents reported having received hip fracture-specific RA training, of whom 52% felt adequately prepared. Knowledge scores (median, IQR) were low for single best answer questions (50%, 39\u201367)\u2009and complications (50%, 38\u201375), but higher for contraindications (83%, 67\u2013100)\u2009and indications (75%, 50\u2013100). Attitudes were broadly positive: 93% viewed RA as safe and effective, and 88% felt all ED doctors should be proficient. Training was mostly informal (94%), predominantly via bedside teaching from an emergency medicine colleague (65%). RA for hip fractures was underused, with 39% reporting never performing it and 27% reporting seldom use. The most cited barrier was a lack of skills (49%), which decreased with increasing ED experience (p=0.012).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite self-reported generally strong positive attitudes towards RA for hip fractures, it remains underused. Insufficient skills and training were the most common self-reported barriers. Future research could be aimed at assessing the impact of standardised training and departmental protocols on clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117834","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:15:51Z","timestamp":1782404151000},"page":"e117834","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Regional analgesia for hip fractures in emergency departments in Johannesburg, South Africa: a prospective cross-sectional survey assessing doctors\u2019 knowledge, attitudes and practices"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5888-4235","authenticated-orcid":false,"given":"Robert Klaus","family":"Uhrich","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine, University of the Witwatersrand, Johannesburg, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"Beringer","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, University of the Witwatersrand, Johannesburg, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Chadinha","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, University of the Witwatersrand, Johannesburg, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"2026062509152421000_16.6.e117834.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-023-06907-3"},{"key":"2026062509152421000_16.6.e117834.2","unstructured":"Royal College of Physicians . 15 years of quality improvement: the 2023 national hip fracture database report on 2022. London, 2023. Available: https:\/\/www.nhfd.co.uk\/FFFAP\/Reports.nsf\/0\/8E1A90378EAFB92E80258A43002E3680\/$file\/NHFD_2023_Annual_Report_v1a.pdf"},{"key":"2026062509152421000_16.6.e117834.3","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1177\/08982643221132450","article-title":"Hip Fracture-Related Emergency Department Visits, Hospitalizations and Deaths by Mechanism of Injury among Adults Aged 65 and Older, United States 2019","volume":"35","author":"Moreland","year":"2023","journal-title":"J Aging Health"},{"key":"2026062509152421000_16.6.e117834.4","unstructured":"Maluleke R . Marginalised groups series volume VI: the social profile of older persons. Pretoria Statistics South Africa; 2023. 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Ultrasound-guided nerve blocks. 2021. 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