I developed this website to act as a single resource for anaesthetists interested in finding out how to improve their delivery of anaesthesia to patients with hip fracture, based on the latest published evidence.
I’ve divided the website into a number of themes, which you can access by clicking at the top of this page:
The evidence for much of how we anaesthetise patients with hip fracture is limited. As a result, there is no consensus on how anaesthesia should best be administered for patients with hip fracture. The evidence-based standards listed here have been developed by consensus among several UK experts, to provide a baseline from which further research can develop. The rationale behind each standard is explained, along with a list of supporting publications.
There are knowledge gaps in how anaesthesia should best be delivered to patients with hip fracture. This section identifies those gaps, and suggests what studies need to be done to answer these questions. The ASAP project showed what is possible by ‘crowdsourcing’ data collection, and I’d be happy to help you develop further any of these research ideas that you are interested in studying. Feel free to contribute further ideas to this section by contacting me.
Apart from the development of orthogeriatrics as a profession, the greatest improvements in hip fracture care over the last decade in the UK have been brought about by standardising hospital treatment pathways, effectively ‘Enhanced Recovery Protocols’ for hip fracture patients. Documents used in these pathways can be accessed in this section. Again, feel free to contact me with ideas about how to improve these.
A number of UK professional guidelines exist which recommend how best to manage the care of patients with hip fracture, links to which can be found in this section. I’d be very interested in adding similar guidelines from other countries …
Hip fracture is perceived as having a very poor outcome, but the majority of patients return home once they recover. This section contains links to information for patients and their relatives about what to expect after breaking a hip.
There are a wealth of instructional videos that are relevant to hip fracture anaesthesia on the web, for example, showing you how to perform specific nerve blocks or discussing aspects of care. Links to these can be found in this section.
Lack of evidence = excess of controversy. I’ll attempt to try and unravel some of these controversies by blogging about them. Let me know what you think!
8. Useful links
Hip fracture management is a complex process involving many different medical specialties. Links to relevant professional websites, interesting articles and all other links of interest can be found in this section.
About the author, Dr. Stuart White, FRCA, BSc, MA
I am Lead Consultant in Anaesthesia for the Elderly at Brighton and Sussex University Hospitals, based at the Princess Royal Hip Fracture Unit, in Haywards Heath, UK. My main research interest involves the perioperative care of elderly patients, particularly those undergoing hip fracture repair. I am national research co-ordinator for the Hip Fracture Anaesthesia Network, and have recently completed the Anaesthesia Sprint Audit of Practice (ASAP), concerning anaesthetic management of hip fracture in the UK. I am a member of the AAGBI working parties Perioperative care of the Elderly 2014 Femoral Fractures 2011, and have advised the UK National Institute of Clinical Excellence (NICE) on the latter. I am an editor of Anaesthesia journal, and edited the 2014 Anaesthesia supplement Anaesthesia for the Elderly. I was awarded the Dudley Buxton Medal by the Royal College of Anaesthetists in 2014, for ‘meritorious work in anaesthesia’ for hip fracture.
I have received no money from commercial industry in connection with my work on hip fracture anaesthesia, and have no conflicts of interest. The opinions presented on this website are independent of the bodies mentioned above.