Lung Ultrasound in the Evaluation of the Medical and Trauma Patient

Traditional evaluation for medical and trauma patients with shortness of breath or thoracic trauma has involved chest radiography. While ultrasound has been included in the Extended FAST exam, it is still common to find the... [ view full abstract ]

Traditional evaluation for medical and trauma patients with shortness of breath or thoracic trauma has involved chest radiography. While ultrasound has been included in the Extended FAST exam, it is still common to find the supine one view chest plain film used instead of an ultrasound evaluation for pneumothorax. Chest plain films have been demonstrated multiple times in the literature to have poor sensitivity for pneumothorax, pulmonary edema and pulmonary edema and yet are still commonly used throughout the hospital. Ultrasound has excellent sensitivity for these entities as well as many others and should be included both in everyday clinical practice and resident training.
We will discuss common protocols for thoracic ultrasound including the Volpicelli and BLUE protocols. Interpretation of lung ultrasound will be described, including defining lung artifacts such as A lines, B lines and Z lines. Finally, using common clinical situations we will discuss the practical use of thoracic ultrasound both in evaluation and treatment of medical and trauma patients both in the hospital and in more austere environments.