Fascia Iliaca Compartment Block

Playlist: Ortho51 Videos

  1. 01:21

    Probe-to-Bone Test for Osteomyelitis

    Uploaded July 2023

  2. 01:03

    Jaw Reduction by Extra-oral Technique - Presented by Al Sacchetti

    Uploaded June 2023

  3. 01:18

    Reduction of an Inferior Shoulder Dislocation

    Uploaded June 2023

  4. 01:20

    FARES Shoulder Reduction Technique

    Uploaded June 2023

  5. 01:32

    Cunningham Shoulder Reduction Technique

    Uploaded June 2023

  6. 01:19

    Stimson Shoulder Reduction Technique with Scapular Manipulation

    Uploaded June 2023

  7. 01:48

    Trigger Point Injection

    Uploaded May 2023

  8. 02:09

    Ganglion Cyst Aspiration and Injection

    Uploaded March 2023

  9. 03:06

    Digital Nerve Block Techniques

    Uploaded February 2023

  10. 03:15

    Finger Reduction

    Uploaded January 2023

  11. 01:53

    Elson and Modified Elson Tests for Central Slip Injury

    Uploaded January 2023

  12. 01:35

    Examining the Flexor Digitorum Tendons

    Uploaded January 2023

  13. 01:23

    Jaw Reduction by Wrist Pivot Maneuver

    Uploaded December 2022

  14. 02:39

    Ankle Arthrocentesis

    Uploaded December 2022

  15. 01:54

    Aspiration of Olecranon Bursitis

    Uploaded October 2022

  16. 01:06

    Reduction of a Lateral Patellar Dislocation

    Uploaded October 2022

  17. 01:36

    Shoulder Reduction by External Rotation

    Uploaded September 2022

  18. 05:16

    Posterior Tibial Nerve Block

    Uploaded July 2022

  19. 01:21

    Reduction of Elbow Dislocation

    Uploaded May 2022

  20. 01:15

    Removal of a Staple Gun Staple

    Uploaded June 2021

  21. 01:38

    Mandible Reduction Classic Technique

    Uploaded June 2021

  22. 01:13

    Traumatic Arthrotomy

    Uploaded May 2021

  23. 03:36

    Nail Bed Laceration Repair

    Uploaded May 2021

  24. 01:11

    Nursemaid's Elbow Reduction with Supination Technique

    Uploaded April 2021

  25. 00:53

    Shoulder Reduction by Davos Technique

    Uploaded April 2021

  26. 00:41

    Biceps Tendon Rupture

    Uploaded July 2020

  27. 00:38

    Thompson Test for Achilles Tendon Rupture

    Uploaded June 2020

  28. 00:56

    Flexor Tenosynovitis

    Uploaded April 2020

  29. 02:06

    Septic Bursitis Aspiration

    Uploaded August 2018

  30. 02:31

    Bone Rongeur for Fingertip Amputation

    Uploaded July 2018

  31. 01:52

    Felon Incision and Drainage

    Uploaded April 2018

  32. 01:21

    Elbow Arthrocentesis

    Uploaded December 2017

  33. 01:29

    Knee Arthrocentesis and Intraarticular Injection

    Uploaded December 2017

  34. 01:20

    Ulnar Nerve Block at the Wrist

    Uploaded December 2017

  35. 01:23

    Hip Reduction by East Baltimore Lift Maneuver

    Uploaded November 2017

  36. 02:07

    Reduction Techniques for Posterior Hip Dislocation

    Uploaded November 2017

  37. 01:36

    Paronychia Incision and Drainage

    Uploaded October 2017

  38. 01:03

    Trephination of a Fingernail Subungual Hematoma with Cautery

    Uploaded October 2017

  39. 02:37

    Removal of Ingrown Toenail

    Uploaded September 2017

  40. 01:44

    Shoulder Joint Injection

    Uploaded July 2017

  41. 01:33

    Subacromial Bursa Injection for Impingement Syndrome

    Uploaded July 2017

  42. 01:20

    Jaw Reduction by Extraoral Technique - Presented by Jess Mason

    Uploaded May 2017

  43. 06:14

    Measuring Compartment Pressure

    Uploaded May 2017

  44. 01:00

    Reduction of Inferior Shoulder Dislocation

    Uploaded April 2017

  45. 00:37

    Reduction of Posterior Shoulder Dislocation

    Uploaded April 2017

  46. 01:12

    Reduction of Anterior Shoulder Dislocation

    Uploaded April 2017

  47. 01:34

    Fish Hook Removal

    Uploaded February 2017

  48. 01:16

    Pelvic Binder Placement

    Uploaded February 2017

  49. 03:18

    Pelvic Fractures

    Uploaded February 2017

  50. 01:40

    Wrist Arthrocentesis

    Uploaded October 2016

Sign in or subscribe to watch the video.

In this short video we review the anatomy and approach to a fascia iliaca compartment block, which aims to block the femoral nerve, obturator nerve, and lateral femoral cutaneous nerve (also called a 3 in 1 block). This is a great block for patients with fractures of the femoral neck, intertrochanteric fractures, or proximal femur fractures. Pain is better controlled with nerve blocks and less opiates are required when this approach is used for hip fractures. This can be done with ultrasound guidance, or with a blind technique. Once the needle is through the fascia lata and fascia iliaca, the anesthetic is injected to dissect the iliacus muscle off the fascia iliaca, and the anesthetic tracks proximally up the fascial plane to anesthetize all 3 nerves (at least in theory!).

To view chapter written summaries, you need to subscribe.

Sign up today for full access to all episodes.

Garrett B. -

Prior to doing the procedure, it is important to ensure you have 20% Intralipid at your facility in the event of local anesthetic systemic toxicity - especially since you're going to be using bupivacaine. These patients can have seizures and go into cardiac arrest due to effect lidocaine and bupivacaine on sodium channels Make sure you know the symptoms of local anesthetic systemic toxicity. http://rebelem.com/local-anesthetic-systemic-toxicity-last/

Robert A. -

Could not agree more. Knowing what to do when things go wrong is the most important part of any procedure.

Abbas F. -

This video demonstrates femoral nerve block, not the fascia iliaca block (how it has been described using ultrasound guidance). Blind technique for the 3 in 1 block is the double "pop" technique where you inject anaesthetic next to femoral nerve and apply distal pressure, hoping that it would track up proximally and anaesthetise the obturator nerve and lateral cutaneous nerve of thigh. Distal pressure can also be applied after ultrasound guided LA injection which may improve the efficacy. Even with ultrasound, this method with distal pressure gives variable results.

A different method has been described for USS guided fascia iliaca compartment block. The primary landmark for initial probe placement is the ASIS, parallel to midline. Then you move your probe up and down, looking for what has been described as the "bow tie" appearance of the transition point between iliacus and sartorius muscles and deposit your desired volume of LA under the fascia iliaca, hydro-dissecting the iliacus away from the facia iliaca. This works quite nicely and is my usual practice now for all NOF fractures in ED.

Victor C. -

Agree w/ this comment. Could you do a video and show technique for fascia iliaca compartment block w/ US probe placed parallel to midline? I find the most difficult step is finding the 'bow tie' sometimes.

John U. -

Is there a good or recommended method to determine depth when doing the blind technique?

To join the conversation, you need to subscribe.

Sign up today for full access to all episodes and to join the conversation.