A bone cement implantation syndrome (BCIS) protocol should be followed when patients are scheduled to receive a cemented prosthesis.

 

Rationale

BCIS occurs in about 20% (and results in cardiopulmonary arrest in about 0.5%) of hip fracture operations in which cement is used [13]

Specific safety guidelines for BCIS have been developed recently, and are freely available online [56]

Use of a protocol

  • increases awareness of BCIS
  • reduces the prevalence of BCIS
  • reduces the severity of BCIS reactions

 

Evidence

1. Royal College of Physicians and the Association of Anaesthetists of Great Britain and Ireland. National Hip Fracture Database. Anaesthesia Sprint Audit of Practice. 2014. http://www.nhfd.co.uk/20/hipfractureR.nsf/welcome?readform (accessed 01/01/2016).

2. Griffiths R, White SM, Moppett IK, et al. Association of Anaesthetists of Great Britain and Ireland; British Orthopaedic Association; British Geriatric Society. Safety guideline: reducing the risk from cemented hemiarthroplasty for hip fracture 2015: Association of Anaesthetists of Great Britain and Ireland British Orthopaedic Association British Geriatric Society. Anaesthesia 2015; 70: 623-6.