Australian and New Zealand ambulance guidelines for neck-of-femur fractures

Abstract

Background: Neck-of-femur (NOF) fractures are common, complex injuries. Paramedics frequently respond to suspected NOF fractures; however, the unique challenges associated with NOF fractures make it critical that prehospital care provided by paramedics is patient-centred and evidence-based. Aims: This study aimed to identify and appraise Australian and New Zealand ambulance service clinical practice guidelines (CPGs) for the management of NOF fractures. Methods: CPGs from eight Australian and two New Zealand ambulance services were identified and manually searched using a priori search terms, their table of contents, and embedded search functions (i.e. mobile apps) to find standalone CPGs for NOF fractures. Findings: No standalone CPG for prehospital NOF fracture management was identified. Five guidelines included the tern ‘NOF’ in the context of general-fracture management or as an indication for advanced pharmacotherapy. Conclusions: The absence of CPGs for NOF fractures could negatively impact patient experience and health outcomes. Efforts should be applied to develop such a CPG to optimise prehospital care.