WAVELENGTHTUNE IN · GAIN CLARITY

Wavelength Academy · Nerve blocks

Ultrasound-guided blocks for the hip and femur: femoral, fascia iliaca and PENG

A fractured neck of femur is the commonest serious injury in older people, and a nerve block on arrival is part of good care. Learn the femoral nerve block, the infra-inguinal and supra-inguinal fascia iliaca blocks and the PENG block: the anatomy, the safety system, how to choose between them and the evidence.

  • 1.5 hours CPD
  • 5 lessons
  • 5 cases
  • 14-question assessment
  • Pass mark 80%
  • Free

Register free and start

What you will learn

  • Explain why early nerve blocks matter in hip fracture, and summarise the evidence
  • Set up a safe block in a frail patient: capacity, dose calculation, monitoring, Stop Before You Block and documentation
  • Perform the sonoanatomy and needle path for the femoral nerve, infra-inguinal and supra-inguinal fascia iliaca and PENG blocks
  • Choose between the blocks for a given injury and patient
  • Recognise the risks of each block, including quadriceps weakness and local anaesthetic toxicity

Lessons

  1. Why the hip fracture patient needs a block12 min
  2. The safety system: dose, Stop Before You Block and toxicity18 min
  3. The femoral nerve block14 min
  4. The fascia iliaca block: below and above the ligament18 min
  5. The PENG block14 min
  6. Cases12 min
  7. Final assessment: 14 questions, pass mark 80%8 min

Who it is for

Emergency and acute care doctors, advanced clinical practitioners and nurses who perform, or are training to perform, ultrasound-guided blocks for hip and femoral fractures under their trust's governance.

Your certificate

Pass the assessment and we email your certificate as a PDF: your name, the module, 1.5 hours of CPD, the date and a code anyone can check at thewavelength.co.uk/elearning/verify. Upload it to your e-portfolio with a short reflection. Wavelength issues the certificate itself. It is not accredited by an external body, so record the hours as self-directed CPD under your own college or regulator's rules. The certificate records completed learning. Sign-off to scan independently stays with your department.

About this module

Author. Dr Firas Abou-Auda, Consultant in Emergency Medicine and Course Director, Wavelength.
Published. October 2026. Next review. October 2028.
Conflicts of interest. Dr Firas Abou-Auda is Course Director of Wavelength, which runs paid ultrasound courses.

References

  1. Guay J, Kopp S. Peripheral nerve blocks for hip fractures in adults. Cochrane Database of Systematic Reviews. 2020;11:CD001159.
  2. Griffiths R, Babu S, Dixon P, et al. Guideline for the management of hip fractures 2020: guideline by the Association of Anaesthetists. Anaesthesia. 2021;76:225-37.
  3. Royal College of Emergency Medicine. Fascia iliaca block in the emergency department. Best practice guideline.
  4. Dalens B, Vanneuville G, Tanguy A. Comparison of the fascia iliaca compartment block with the 3-in-1 block in children. Anesthesia and Analgesia. 1989;69:705-13.
  5. Hebbard P, Ivanusic J, Sha S. Ultrasound-guided supra-inguinal fascia iliaca block: a cadaveric evaluation of a novel approach. Anaesthesia. 2011;66:300-5.
  6. Desmet M, Vermeylen K, Van Herreweghe I, et al. A longitudinal supra-inguinal fascia iliaca compartment block reduces morphine consumption after total hip arthroplasty. Regional Anesthesia and Pain Medicine. 2017;42:327-33.
  7. Girón-Arango L, Peng PWH, Chin KJ, Brull R, Perlas A. Pericapsular nerve group (PENG) block for hip fracture. Regional Anesthesia and Pain Medicine. 2018;43:859-63.
  8. Association of Anaesthetists. Management of severe local anaesthetic toxicity. Safety guideline. 2010.
  9. Regional Anaesthesia UK and the Safe Anaesthesia Liaison Group. Stop Before You Block.

Read the free Wavelength Pearl on this topic