Inclusion Criteria:  Adult Emergency Medicine Patients over 18 years of age Isolated hip fracture, intertrocanteric or more proximal Pain score 5 or greater on a scale of 0 to 10 just prior to nerve block placement  Exclusion Criteria:  Patients with multi-system trauma People who are unable to communicate their level of pain\ Pregnant patients Pediatric Patients (less than 18 years of age) Intoxicated Patients Abnormal Vital Signs (HR>120bpm, MAP <65, Pulse Ox <95%) Patients on long term systemic opioid analgesia Allergy to amide local anesthetics