The purpose of this study is to determine the feasibility of using the ultrasound-guided erector spinae plane blocks to provide additional pain relief to patients with rib fractures in the Emergency Department (ED) and Intensive Care Unit (ICU).

Inclusion Criteria:

• Patients 18 years old or older.
• Patients with one or more acute traumatic rib fractures.

Exclusion Criteria:

• Inability to position appropriately.
• Unconscious or heavily sedated.
• Patients who are critically ill such that care should not be delayed for regional anesthesia.
• Patients under the age of 18 years old.
• Vulnerable populations including prison inmates and pregnant patients.
• Overlying skin infection, wound, or dressing/equipment (i.e., Chest tube).
• Inability to visualize target anatomy or by ultrasound or anatomy prohibitive for other reasons to perform procedure successfully.
• Known or documented allergy to ropivacaine or other amide local anesthetic.