Femoral Nerve Block
When to block:
Patients presenting with:
• Hip Fractures (excluding subcapital fractures)
• Femoral Fractures
Amount of anesthetic:
• ~20cc 0.5% bupivacaine (Femoral Nerve Block)
• ~40cc 0.25% bupivacaine (Fascia Iliaca Block)
• Bupivacaine max dose: 2-2.5mg/kg (175mg/dose)
Use sterile/semi-sterile technique.
Monitor patient on cardiac monitor for 30-60min (re LAST).
Where you put the probe and needle:

• Inguinal Crease
• Use in plane technique with lateral to medial approach of the needle

Internal Landmarks:
• Femoral Nerve is lateral to Artery and Vein
• Locate femoral nerve above femoral artery bifurcation

• Purple line: Fascia Lata
• Blue line: Fascia Iliaca
• Red circle: Femoral artery
• Yellow oval: Femoral nerve
![COMPRESS GIF 10 FPS DEIDENTIFIED MP4 14.54.08 hrs __[0003503] COMPRESS GIF 10 FPS DEIDENTIFIED MP4 14.54.08 hrs __[0003503]](https://www.bcpocus.ca/wp-content/uploads/2019/07/COMPRESS-GIF-10-FPS-DEIDENTIFIED-MP4-14.54.08-hrs-__0003503.gif)
• Needle entry lateral to iliopsas, in-plane
• Local anesthetic is injected under the fascia iliaca at a safe distance from the neurovascular bundle
• The needle tip can be 1-2 cm away from the nerve, just ensure anesthesia is spreading in the correct fascial plane!
![COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.14 hrs __[0006680] COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.14 hrs __[0006680]](https://www.bcpocus.ca/wp-content/uploads/2019/07/COMPRESS-GIF-10-FPS-DEIDENTIFIED-MP4-12.46.14-hrs-__0006680.gif)
• Needle tip at fascia iliaca
![COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.52 hrs __[0006681] COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.52 hrs __[0006681]](https://www.bcpocus.ca/wp-content/uploads/2019/07/COMPRESS-GIF-10-FPS-DEIDENTIFIED-MP4-12.46.52-hrs-__0006681.gif)
• Injecting anesthetic deep to fascia lata and fascia iliaca (lateral to artery and nerve)

• Inguinal Crease
• Use in plane technique with lateral to medial approach of the needle

Internal Landmarks:
• Femoral Nerve is lateral to Artery and Vein
• Locate femoral nerve above femoral artery bifurcation

• Purple line: Fascia Lata
• Blue line: Fascia Iliaca
• Red circle: Femoral artery
• Yellow oval: Femoral nerve
![COMPRESS GIF 10 FPS DEIDENTIFIED MP4 14.54.08 hrs __[0003503] COMPRESS GIF 10 FPS DEIDENTIFIED MP4 14.54.08 hrs __[0003503]](https://www.bcpocus.ca/wp-content/uploads/2019/07/COMPRESS-GIF-10-FPS-DEIDENTIFIED-MP4-14.54.08-hrs-__0003503.gif)
• Needle entry lateral to iliopsas, in-plane
• Local anesthetic is injected under the fascia iliaca at a safe distance from the neurovascular bundle
• The needle tip can be 1-2 cm away from the nerve, just ensure anesthesia is spreading in the correct fascial plane!
![COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.14 hrs __[0006680] COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.14 hrs __[0006680]](https://www.bcpocus.ca/wp-content/uploads/2019/07/COMPRESS-GIF-10-FPS-DEIDENTIFIED-MP4-12.46.14-hrs-__0006680.gif)
• Needle tip at fascia iliaca
![COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.52 hrs __[0006681] COMPRESS GIF 10 FPS DEIDENTIFIED MP4 12.46.52 hrs __[0006681]](https://www.bcpocus.ca/wp-content/uploads/2019/07/COMPRESS-GIF-10-FPS-DEIDENTIFIED-MP4-12.46.52-hrs-__0006681.gif)
• Injecting anesthetic deep to fascia lata and fascia iliaca (lateral to artery and nerve)