RAPID – Rapid Analgesia for Prehospital Hip Disruption

Principal / Lead Investigator
  • Nigel Rees, Welsh Ambulance Service Trust (WAST).
Co-Investigators / Research Team
Type of study

Feasibility randomised controlled trial


Breaking a hip is very painful and moving a patient with a broken hip can cause high levels of pain and distress.  It has been found that patients attended by emergency ambulance paramedics following a 999 call for hip fracture may not receive adequate pain relief, and the usual analgesia given may cause side effects that affect patients’ general health and recovery.  Fascia Iliaca Compartment Block (FICB) is a procedure routinely undertaken by doctors and nurses in the emergency department for patients with hip fracture but has not been tested for use by paramedics at the scene of 999 calls.  The procedure involves injection of local anaesthetic into the hip area.

Aim of the research
In this small study we aim to find out whether FICB carried out by paramedics at the scene of 999 emergencies is feasible, safe and acceptable so that we can make a decision about whether we should proceed to a full randomised controlled trial that can answer questions about whether the procedure is effective for patients and worthwhile for the NHS.

In this feasibility study we will recruit approximately 10 paramedics in the Swansea area.  Paramedics will be trained to carry out the FICB procedure on patients they attend with hip fracture.  Eligible patients will be randomly allocated to FICB or usual care using sealed envelopes on ambulances, a method currently successfully being used by the Welsh Ambulance Service in another study – PARAMEDIC 2 (the ‘Adrenaline trial’).  We will follow up patients to assess accuracy of paramedic diagnosis, acceptability to patients and paramedics, compliance of paramedics and also measures of pain, side effects, time in hospital and quality of life in order to plan a full trial if appropriate.


At the end of this study we will make a recommendation about whether a full randomised controlled trial of FICB by paramedics for hip fracture is warranted, and if so, we will produce a proposal for research funding in order to take the work forward.

Link with RDG / CSG or similar


Who is the study sponsor?

Welsh Ambulance Service Trust (WAST)


Health and Care Research Wales, through the Research for Patient and Public Benefit funding call 

Total grant value


Amount to Centre


Start date


End date


Outputs generated

Bulger J, Brown A, Evans BA, Fegan GW, Ford S, Guy K, Keen L, Pallister I, Rees N, Russell D, Russell IT, Seagrove AC, Snooks HA. Rapid analgesia for prehospital hip disruption (RAPID): protocol for feasibility study of randomised controlled trial. Pilot and Feasibility Studies 2017 3:8 DOI: 10.1186/s40814-016-0115-6