Page 20 - SREMI 2020 Annual Report

SREMI Research Chair
DR. JACQUES LEE
The SREMI Inaugural Research Chair in Geriatric Emergency Medicine Dr. Jacques Lee has continued to transition his existing geriatric-EM research program while maintaining forward momentum.
Emergency Department Use of Regional Anesthesia to Prevent Incident Delirium (EDU-RAPID)
Multiple systematic reviews have established that traditional narcotics provide sub-optimal analgesia for patients suffering a hip fracture. Regional anesthesia, also known as a nerve- block, provides more effective and faster pain relief, and is safer especially when guided by point-of-care ultrasound (POCUS).
Dr. Lee previously established that less than 5% of emergency physicians routinely performed nerve blocks for patients with a hip fracture. Over the past few years, Dr. Lee has been leading a national, CIHR-funded, multi-centred randomized clinical trial aimed to reduce delirium in older adults suffering from a hip fracture. The goal of the EDU-RAPID trial was to determine if teaching and encouraging emergency physicians to perform ultrasound guided hip nerve blocks could reduce delirium by improving pain without the need for sedating narcotics.
Over 200 emergency physicians have been successfully trained in the hip-block procedure and have completed over 840 nerve blocks for older patients presenting to the emergency department with a hip fracture. However, training a large cohort of emergency physicians has extended the impact of the research beyond the 840 trial participants. Improbably, one of the study’s own co-investigators, who was too young to participate in the trial, suffered a hip fracture in a cycling accident in November 2019. His signi cant pain was rapidly relieved after receiving a nerve-block from a 4th year resident who was trained and supervised by an EDU-RAPID trained physician.
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