J Emerg Med
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Rib fractures are frequently diagnosed and treated in the emergency department (ED). Thoracic trauma has serious morbidity and mortality, particularly in older adults, with complications including pulmonary contusions, hemorrhage, pneumonia, or death. Bedside ED-performed ultrasound-guided anesthesia is gaining in popularity, and early and adequate pain control has shown improved patient outcomes with rare complications. ⋯ Thoracic nerve blocks (e.g., ESP, SANB, ICNB) can be performed safely by appropriately trained emergency physicians, provide excellent anesthesia for rib fractures and thoracic trauma, and should be strongly considered for improved patient-centered outcomes. Furthermore, performing regional nerve blocks in the emergency department can reduce complications including adverse effects from opioids or other delirium-inducing medications.
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Vision, Aphasia, and Neglect (VAN), Ventura Emergent Large Vessel Occlusion (VES), and Large Artery Intracranial Occlusion (LARIO) are promising stroke screening tools that were shown to have high diagnostic performance to detect Emergent Large Vessel Occlusion (ELVO) in their derivation studies. ⋯ The comparable diagnostic performance of VAN, VES, and LARIO to the NIHSS, in addition to their straightforwardness and rapid evaluation time, can facilitate optimal care for patients with ELVO in prehospital or ED triage settings.