• Henry Ashworth, Spencer Tagg, and Erik Anderson.
• Alameda Health System, Highland Hospital, Department of Emergency Medicine, Oakland, CA, USA. Electronic address: hcashwor@gmail.com.
• Am J Emerg Med. 2024 Jan 1; 75: 196.e5196.e7196.e5-196.e7.

IntroductionProper pain in acute scapular fractures can be challenging to achieve due to their anatomy and location. While the current mainstay of treatment relies on opioids, the Rhomboid Intercostal Block (RIB) has been utilized for anesthesia to effectively treat pain for scapular fractures. However, it has not yet been utilized in the emergency department (ED).Case ReportIn this case report, we present the first documented use of RIB to treat pain safely and effectively in a 69-year-old male with a scapula fracture following a ground-level fall in the ED. The RIB was performed under ultrasound guidance, providing precise localization and administration of the nerve block.ConclusionThe RIB demonstrated successful pain management in the ED. Although hopeful, further research is needed to understand limitations, potential side effects, length of pain control, and overall clinical outcomes of the RIB in the ED.Copyright © 2023 Elsevier Inc. All rights reserved.

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