Nerve Block Gallery - Sub-Serratus Anterior Plane Block
Caption
60s F presented to the ED three days after a fall at home, complaining of right chest pain, and was found to have multiple rib fractures on CT with a small amount of hemothorax and blood in the horizontal fissure. A serratus anterior plane block was performed using an in-plane approach to inject anesthetic in the fascial plane between the pectoralis minor and serratus anterior muscles (not shown), followed by this injection into the fascial space between the rib and serratus anterior. Additionally, fluid (likely blood) can be seen here in the pleural space below the rib. 30 minutes after the nerve block, the patient was feeling much improved, her performance on incentive spirometry improved markedly, and she requested discharge. Dr. Michael Heffler, PGY3 Denver Health Residency in Emergency Medicine