• HurdleMark Friedrich BMFBDepartment of Pain Medicine, Mayo Clinic College of Medicine and Science, Jacksonville, Florida, USA., Guilherme Ferreira-Dos-Santos, Raul Rosario-Concepcion, Laura V Gil, Jason S Eldrige, and Steven R Clendenen.
• Department of Pain Medicine, Mayo Clinic College of Medicine and Science, Jacksonville, Florida, USA.
• Reg Anesth Pain Med. 2021 May 1; 46 (5): 452-454.

AbstractOver the last two decades, the clinical applications of diagnostic and interventional ultrasound have expanded rapidly. When analyzing the chest wall and thoracic region, ultrasound has previously been shown to reliably identify chest wall pathologies like rib fracture and slipping rib syndrome, as well as having fundamentally changed perioperative management and patient outcomes after the emergence of point-of-care ultrasound. In addition, ultrasound guidance has recently become more popular for multiple blocks in the field of regional anesthesia and pain medicine. In this technical report, we systematize an ultrasound-guided protocol for counting ribs and thoracic levels for both posterior and anterior approaches, which does not require level confirmation by fluoroscopy. With this protocol, we hope to create an effective educational resource to support physicians from any specialty background as they engage in point-of-care ultrasound applications in the thoracic region.© American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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