Supraclavicular BP block

9 – Always place the probe on top of the first rib and you will see the pleura

It is important to locate the probe on top of the first rib

With in-plane needle approach the needle tip will impinge on the rib instead of producing a pneumothorax, if the needle is inserted too deep

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The movie shows the typical sonographic image when the probe is placed on top of the first rib
P = pleura, c1 = first rib, SA = subclavian artery, asterixs = nerve divisions of the brachial plexus. Post = posterior, ant = anterior