Trochanteric and Femoral Neck Fragility Fracture Guidelines

Patient Demographics:
Mechanism: Falls from standing height
Age 50 yrs. and over
Sex: Male and female

Labs to be ordered in addition to standard pre-op labs:

• Vitamin D 25-Hydroxy
• Parathyroid Hormone

Chemical DVT Prophylaxis:

• If patient is a candidate for spinal anesthesia then hold chemical DVT ppx to allow for spinal anesthesia. If not a candidate for spinal anesthesia then may begin chemical DVT ppx.

***Use the Fragility Fracture MPP available in Care4 (all pre op orders available through MPP).

All patients should have APMS consulted for Block:

Protocol for Ordering the Fascia Iliaca Block

1. The Orthopaedic Trauma Service will assess the patient in the Emergency room
2. If the patient is admitted, the orthopaedic representative will call the acute pain service which has 24-hour nurse coverage at 4-9762 and request the block
3. Inform the ER attending that the block has been ordered
4. If there are issues the following contact information is available
   1. Acute pain attending 4-9763
   2. During the day 6a-6p the block nurses can be reached at 4-3027
   3. Block attending or fellow 4-2069
   4. Block resident 4-2068
   5. The resident team leader at night 4-8998
   6. Nadia Hernandez 832-289-5882