Point of Care Lung Ultrasound

Sudhir Datar, M.D.,

Department of Neurology,

Neurocritical care,

Wake Forest Baptist Health.

• I have no relevant financial disclosures

Objectives

• Introduction to point of care pulmonary ultrasound

• Indications

• Use of lung ultrasound in clinical decision making

• Pleural effusion, pulmonary edema, pneumothorax

Case study

• 65 year old woman with history of CHF with EF 25%,

COPD with 60 pack year smoking history and history of

lung fibrosis from chronic use of amiodarone

• Presents with shortness of breath to the ER

• CHF exacerbation vs COPD exacerbation vs CAP or a

combination of these?

Advantages

• Better portability

• Real time imaging

• Guidance during procedures

• Differentiating effusion from infiltrates

• Early detection of procedure related complications such as pneumothorax

• Absence of radiation

Disadvantages

• Operator dependent

• Needs expertise and training

• Less informative than CT scan for certain complex pleural

and parenchymal pathology

• Not better than CT for interventional procedures

Indications

• Bedside detection of pleural effusion

• Early detection of pneumothorax following central line

placement

• Guidance for thoracentesis

• Differentiating between pleural masses/thickening vs

pleural fluid

Ultrasound Basics

• Lower frequency = more penetration but at the cost of less

resolution

• Higher frequency = less penetration with greater resolution

Probes

Curvilinear probe- 2-5 MHz Linear probe- 5-10 MHz

Lung Ultrasound Approach

Current Cardiology Reviews, 2012, 8, 123-136

Approach to lung USG

Normal lung

(Artifacts)

Longitudinal position

Pleural lineRibArtifacts

A line

artifact

Normal lung (Artifacts)

Mirror Image

Abdominal Approach

The mirror sometimes does lie

A lines

B lines

Lung sliding

Pneumothorax

• 176 blunt trauma patients

• Prospective study

• CXR sensitivity 75%, specificity 100%

• Ultrasound sensitivity 98%, specificity 99%

Blaivas, et al. AEM 2005; 12.

Pneumothorax

• Sliding can be absent in

• Advanced COPD

• Pleural adhesions

• Pleural effusion

• Chest tubes

Lung point

Pneumothorax M-Mode

Seashore sign Barcode sign

Pleural Effusion

Pleural effusion

Spleen

Effusion

Pleural effusion

Point of Care Lung Ultrasound - Amazon Web...

Documents

Point of Care Ultrasound Curriculum Guidelines (2014)

Premium Performance & Point-of-Care Ultrasound … probes Premium Performance & Point-of-Care Ultrasound Diagnosis and Followup Wireless & Apps Interventional The unique “Twice …

Ultrasound Point of Care Course

Point of Care Ultrasound University · "Point of Care Ultrasound University offers rigorous instruction in multi-system integrated ultrasonography for management of critically ill

Common pitfalls in point-of-care ultrasound: a practical ...Blanco and Volpicelli Crit Ultrasound J DOI 10.1186/s13089-016-0052-x REVIEW Common pitfalls in point-of-care ultrasound:

Teaching Point-of-Care Ultrasound in Medicine: a scoping

New Ultrasound Guidelines: Emergency, Point-of-care, and Clinical … · 2018. 5. 15. · Ultrasound Guidelines: Emergency, Point-of -care, and Clinical Ultrasound Guidelines in Medicine

Ultrasound Guidelines: Emergency, Point-of-care, and ... · Ultrasound Guidelines: Emergency, Point-of -care, and Clinical Ultrasound Guidelines in Medicine Page 3 of 46 examination,

Point-of-care ultrasound COVID-19 · Point-of-care Ultrasound in COVID-19 Nilam J. Soni, MD, MS Professor of Medicine South Texas Veterans Health Care System ... 4-Point Lung Ultrasound

Point of Care Ultrasound (PoCUS) in Palliative Care

Doppler Ultrasound - Amazon Web Servicesaium.s3.amazonaws.com/events/ann2015/fetus/13doppler.pdfDoppler Effect: Application to Obstetrics . The Doppler shift arrives to the transducer

The Views for Point-of- care Echocardiography - asecho.org 12 (Saturday) - Point... · Point-of-care echo • AKA bedside ultrasound, emergency ultrasound, focused ultrasound •

undamentals of Point of Care Ultrasound - Philips · Philips Ultrasound Point of Care POC 218 This comprehensive one-day course focuses on an introduction to the use of point of care

Ultrasound Applications in Critical Care Medicinedownloads.hindawi.com/journals/specialissues/437848.pdf · Point-of-care ultrasound applications such as lung ultrasound are gradually

Reflections on the Development of a Multidisciplinary Point of Care Ultrasound … · 2014-04-24 · Reflections on the Development of a Multidisciplinary Point of Care Ultrasound

10-POINT MUSCULOSKELETAL ULTRASOUND OF THE KNEE

Defining the learning curve of point-of-care ultrasound

Point of Care Ultrasound - Amazon Web Servicesaium.s3.amazonaws.com/events/sem2016/10clues.pdf · Ultrasound Examination: Indications, Components, and Qualifications. J Ultrasound

Computer-Augmented Point-of-Care Ultrasound...- Shaping the future of ultrasound Philips Lumify. Future: Computer-Augmented Point-of-Care Ultrasound 1) Task-specific devices 2) Apps

Teaching point-of-care transfontanellar ultrasound for