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The survey showed that 74% EDs in the UK had access to ultrasound, but only 10% EDs gave FNB regularly under ultrasound guidance. In total, 46% of EDs gave FNB by blind technique. Therefore, ultrasound-guided FNB is an underutilised method of providing pain relief for fractured femur patients. The main reasons for not using ultrasound for FNB were: lack of training, participants\u2019 confidence in giving an effective and safe FNB block blindly and time constraints. The literature review suggests that ultrasound-guided FNB has a faster onset of action, is more effective and safer than the FNB given with nerve stimulator (NS) or blindly, and probably needs lower local anaesthetic dose. The use of NS for FNB in ED might not be practical because of the likelihood of the pain resulting from the movement of the affected limb due to the contraction of the muscles caused by nerve stimulation and because of additional training needed in using NS. The studies comparing FNB given using ultrasound or NS, or given blindly, have been done in the perioperative settings. To date, there has been no randomised controlled trial in ED setting comparing FNB given blindly or under ultrasound guidance. Such a study might have provided a good evidence for modifying the current practice of blind FNB.<\/jats:p>","DOI":"10.1136\/emermed-2012-201546","type":"journal-article","created":{"date-parts":[[2013,2,27]],"date-time":"2013-02-27T02:39:20Z","timestamp":1361932760000},"page":"143-147","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Femoral nerve blocks in fractures of femur: variation in the current UK practice and a review of the literature"],"prefix":"10.1136","volume":"31","author":[{"given":"Rajnish","family":"Mittal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Era","family":"Vermani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,2,26]]},"reference":[{"key":"2024052700102025000_31.2.143.1","unstructured":"Clinical Standards for Emergency Departments, Clinical Effectiveness Committee, The College of Emergency Medicine, 2009."},{"key":"2024052700102025000_31.2.143.2","doi-asserted-by":"publisher","DOI":"10.1136\/emj.5.3.173"},{"key":"2024052700102025000_31.2.143.3","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1302\/0301-620X.77B6.7593107","article-title":"Femoral nerve block in extracapsular femoral neck fractures","volume":"77-B","author":"Haddad","year":"1995","journal-title":"J Bone Joint Surg [Br]"},{"key":"2024052700102025000_31.2.143.4","doi-asserted-by":"publisher","DOI":"10.1136\/emj.4.3.163"},{"key":"2024052700102025000_31.2.143.5","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2003.51"},{"key":"2024052700102025000_31.2.143.6","doi-asserted-by":"crossref","first-page":"218","DOI":"10.2106\/JBJS.H.00314","article-title":"Femoral nerve block for diaphyseal and distal femoral fractures in the emergency department. 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