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 below.
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. I’ve included suggested ‘recipes’ for how to give a spinal anaesthetic and a general anaesthetic (both + nerve block) for hip fracture surgery. Again, feel free to contact me with ideas about how to improve these.
Here’s a great one page guide on how to manage NOACs in the peri-operative period. Laminate and stick on your theatre drug cupboards! Thanks to Dr. Helen Wilson from the Royal Surrey County Hospital for developing this.
This is a document developed by Dr. Lucy White from Southampton, UK, which informs junior doctors how to prepare hip fracture patients so that their surgery is not delayed for medical reasons.
Here’s how I do it, based on the best evidence available …
And again …!
This is a large print questionnaire that lets patients provide feedback to anaesthetists about the anaesthtic care they received.
This is a suggested analgesia decision tree for use in Accident and Emergency.
This is suggested care pathway program that can be modified to accommodate local hospital practices.
The 4AT is a validated rapid assessment test for delirium and cognitive impairment. It is widely used in routine clinical practice in the UK and internationally.
The EQ-5D™ is a standardised instrument for use as a single index measure of health status, which is applicable to a wide range of health conditions and treatments