Indications

Indications

  • All trauma patients in whom a chest x-ray is indicated or a FAST exam is performed
  • Clinical suspicion of pneumothorax
  • During systematic assessment of lungs with PoCUS in dyspneic patient

Equipment

  • Ultrasound machine
  • Linear* or curvilinear transducer
    Gel
    *Linear probe is preferred for investigating pleural pathology

Technique

  • Position the patient supine
  • Place the probe longitudinally on the anterior chest between the parasternal and mid-clavicular lines below the clavicle (Figure 1).
  • Identify chest wall, rib and pleural line.
  • Assess for markers of lung sliding.
  • Slide one rib space down and repeat.
  • Slide down another rib space and repeat.
  • Repeat on the opposite side.
Figure 1: Probe position

TIPS

  • Air collects anteriorly if not limited by adhesions
  • Try to maintain the probe perpendicular to the curved chest wall
  • Sweep the probe to obtain the sharpest view of the pleural line
  • Hold the probe as still as possible when evaluating for pneumothorax to not confuse movement of the probe with movement of the pleura