Fascia iliaca block training for emergency clinicians
The fascia iliaca block (FIB) is a regional anaesthetic technique used in the emergency department for patients with hip fracture. This guide summarises what fascia iliaca block training involves, based on the Royal College of Emergency Medicine (RCEM) best practice guideline.
Source: RCEM, Fascia Iliaca Block in the Emergency Department, best practice guideline, October 2025. Always follow your own department's policy.
What RCEM recommends
- FIB should be available in emergency departments as part of routine pain management for hip fracture.
- Ultrasound-guided FIB is preferred where training and equipment allow, as long as it does not delay the block. The landmark technique is an acceptable alternative.
- Monitor patients for at least 1 hour afterwards for signs of local anaesthetic toxicity and for sedation from other analgesia.
- Intralipid should be readily available.
Who can perform the block
RCEM advises that only clinicians signed off as competent perform FIB, using a documented process, ideally a Direct Observation of Procedural Skills (DOPS) assessment. Before assessment, the guideline describes attending teaching, observing the procedure and completing three supervised blocks. It also advises reassessment if more than six months pass between procedures, and a departmental log of competent staff.
Safety points covered in training
- Contraindications, including patient refusal, allergy to local anaesthetic, coagulopathy, infection at the injection site and previous femoral vascular surgery.
- Dose calculation by body weight, and aspirating regularly during injection.
- Recognising and managing local anaesthetic systemic toxicity.
- Using a "Stop before you Block" check.
Where it fits in the curriculum
Fascia iliaca block is one of the two procedural point-of-care ultrasound applications in the RCEM 2021 curriculum, introduced in core training. Read more in our guide to POCUS training in the UK.
Upcoming fascia iliaca block course dates
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Train with Kung Medics
Our half-day ultrasound-guided fascia iliaca block course runs in Manchester and carries 4 CPD points accredited by The CPD Group. A course supports, but does not replace, sign-off in your own department. See all our ultrasound courses.
Frequently asked questions
Is ultrasound guidance required for a fascia iliaca block?
RCEM prefers ultrasound-guided FIB where training and equipment allow, provided it does not delay the block. The landmark technique is an acceptable alternative.
How long should patients be monitored after a fascia iliaca block?
RCEM advises monitoring for at least 1 hour for signs of local anaesthetic toxicity and for sedation from other analgesia.
How do I become signed off to perform fascia iliaca blocks?
RCEM describes teaching, observing the procedure, three supervised blocks and a documented competence assessment, ideally a DOPS. Follow your department's policy.
How many CPD points does the fascia iliaca block course carry?
4 CPD points, accredited by The CPD Group, according to our booking system.