in this video we see the linear scanner on a nerve preset here in the transverse plane on the medial forearm and in the center of the screen is the median nerve which is going to be anesthetized and an ultrasound guided nerve block this is a 25 gauge needle in the longitudinal plane so visualizing the entire needle and the tip visualizing spread of anesthetic initially on top of the median nerve here which can be identified in the center as a honeycomb structure with fascial planes surrounding it and running in both directions the needle is redirected to apply some anesthesia here on the outer aspect of the nerve and then placed below the nerve to get full circumferential spread of anesthetic to really deliver effective anesthesia to this patient in the emergency department you