Inclusion Criteria:  18 years or older Radiological evidence of 3 or more rib fractures Within 48 hours of admission to hospital with rib fractures Can actively participate by answering questions during TEA or ESPB placement Moderate-severe (4-10 out of 10) pain at the time of enrollment  Exclusion Criteria:  Greater than 48 hrs since admission to the hospital with rib fractures Patient refusal Prisoner Infection at the site of TEA or ESPB insertion Allergy to local anesthetics Depth from skin to catheter placement target 6 or more centimeters Greater than 7 consecutive ribs involved on each side Other regional or epidural block already received Unable to follow commands/altered mental status Dementia Sepsis (temperature > 38 degrees Celsius & positive blood cultures) Elevated intracranial pressure (ICP > 12 mm Hg) Coagulopathy (INR > 1.4) or recent therapeutic anticoagulant use (varies with which medication the patient is on) Preexisting central nervous system disorders, such as multiple sclerosis Thrombocytopenia (Platelets <70,000) Spine fracture or previous back surgery Preload dependent states (aortic stenosis, hypertrophic obstructive cardiomyopathy) Aortic transection Hemodynamic instability (patients with MAPs <60 and/or patients requiring pressor support) Tattoo at sight of catheter placement