Ultrasound: Lungs: Difference between revisions
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(BLUE protocol for lung utz added) |
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***White lines from the pleura to the bottom of the screen | ***White lines from the pleura to the bottom of the screen | ||
***Highly sensitive for pulmonary edema, but can be present at low wedge pressures | ***Highly sensitive for pulmonary edema, but can be present at low wedge pressures | ||
==BLUE (Bedside Lung Ultrasound in Emergency) Protocol== | |||
*Predominant A lines + lung sliding = Asthma/COPD | |||
*Multiple predominant B lines anteriorly with lung sliding = Pulmonary Edema | |||
*Normal anterior profile + DVT = PE | |||
*Anterior absent lung sliding + A lines + lung point = Pneumothorax (PTX) | |||
*Anterior alveolar consolidations, anterior diffuse B lines with abolished lung sliding, anterior asymmetric interstitial patterns, posterior consolidations or effusions w/o anterior diffuse B lines = Pneumonia (PNA) | |||
*[http://ccm.anest.ufl.edu/files/2012/08/BLUELung.pdf Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure - The BLUE Protocol] | |||
**Must read for EM Physicians in using ultrasound for dx in acute respiratory failure | |||
==See Also== | ==See Also== | ||
Revision as of 08:41, 31 December 2013
Pulmonary edema
- A lines and B lines
- A lines:
- Appear as horizontal lines
- Indicate dry interlobular septa.
- Predominance of A lines has 90% sensitivity, 67% specificity for pulmonary artery wedge pressure <= 13mm Hg
- A line predominance suggests that intravenous fluids may be safely given without concern for pulmonary edema
- B lines ("comets"):
- White lines from the pleura to the bottom of the screen
- Highly sensitive for pulmonary edema, but can be present at low wedge pressures
- A lines:
BLUE (Bedside Lung Ultrasound in Emergency) Protocol
- Predominant A lines + lung sliding = Asthma/COPD
- Multiple predominant B lines anteriorly with lung sliding = Pulmonary Edema
- Normal anterior profile + DVT = PE
- Anterior absent lung sliding + A lines + lung point = Pneumothorax (PTX)
- Anterior alveolar consolidations, anterior diffuse B lines with abolished lung sliding, anterior asymmetric interstitial patterns, posterior consolidations or effusions w/o anterior diffuse B lines = Pneumonia (PNA)
- Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure - The BLUE Protocol
- Must read for EM Physicians in using ultrasound for dx in acute respiratory failure