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Ultrasound-guided trunk blocks: erector spinae plane and rectus sheath

Two plane blocks for the trunk: the erector spinae plane block for rib fractures near the spine and thoracic pain, and the rectus sheath block for the central abdominal wall. Learn the safety system, the sonoanatomy, the needle path, the coverage and the limits of each.

  • 1 hour CPD
  • 4 lessons
  • 4 cases
  • 12-question assessment
  • Pass mark 80%
  • Free

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What you will learn

  • Set up a safe plane block: consent, dose calculation, monitoring, Stop Before You Block and documentation
  • Tell a transverse process from a rib on ultrasound and perform the erector spinae plane block
  • Identify the rectus sheath layers, the inferior epigastric vessels and the arcuate line, and perform the rectus sheath block
  • Choose between chest wall blocks for a rib fracture by its position
  • Recognise the limits of each block, including abdominal wall blocks masking intra-abdominal pathology

Lessons

  1. Plane blocks for the trunk10 min
  2. The safety system: dose, Stop Before You Block and toxicity18 min
  3. The erector spinae plane block15 min
  4. The rectus sheath block14 min
  5. Cases10 min
  6. Final assessment: 12 questions, pass mark 80%7 min

Who it is for

Emergency and acute care doctors and advanced clinical practitioners who perform, or are training to perform, ultrasound-guided regional anaesthesia under their trust's governance.

Your certificate

Pass the assessment and we email your certificate as a PDF: your name, the module, 1 hour of CPD, the date and a code anyone can check at thewavelength.co.uk/elearning/verify. Upload it to your e-portfolio with a short reflection. Wavelength issues the certificate itself. It is not accredited by an external body, so record the hours as self-directed CPD under your own college or regulator's rules. The certificate records completed learning. Sign-off to scan independently stays with your department.

About this module

Author. Dr Firas Abou-Auda, Consultant in Emergency Medicine and Course Director, Wavelength.
Published. October 2026. Next review. October 2028.
Conflicts of interest. Dr Firas Abou-Auda is Course Director of Wavelength, which runs paid ultrasound courses.

References

  1. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Regional Anesthesia and Pain Medicine. 2016;41:621-7.
  2. Partyka C, et al. Serratus anterior plane blocks for early rib fracture pain management: the SABRE randomized clinical trial. JAMA Surgery. 2024;159:810-17.
  3. Willschke H, Bösenberg A, Marhofer P, et al. Ultrasound-guided rectus sheath block in paediatric anaesthesia: a new approach to an old technique. British Journal of Anaesthesia. 2006;97:244-9.
  4. Association of Anaesthetists. Management of severe local anaesthetic toxicity. Safety guideline. 2010.
  5. Regional Anaesthesia UK and the Safe Anaesthesia Liaison Group. Stop Before You Block.

Read the free Wavelength Pearl on this topic