Indications
- Dyspnea
- Cough
- Fever without a source
Equipment
- Ultrasound machine
- High frequency linear probe (6-12 MHz) is most used, although a curvilinear or phased array probe may also be used
- Gel
Technique
- Position the patient: It is easiest to completely expose the thorax. LUS can be conducted with the patient in any number of positions; in the parent’s arms (helpful for posterior exam), seated on or lying in a stretcher (lateral decubitus can be used to examine the posterior chest).
- Warm the gel if possible: Younger or sleeping patients may respond better if the gel is warmed. Consider warming the gel between your gloved hands and applying a layer of warmer gel to the chest.
- Scan the patient:
- Set the depth to between 5 – 10 cm, choosing the smallest depth that gives an appropriate image to maximize resolution.
- Hold the probe with the marker pointed towards the patient’s head. Starting most cephalad with the probe in a sagittal orientation scan from the lung apex to the diaphragm.
- Complete this process in 6 planes: posterior between the spine and the scapula left and right chest, at the mid-axillary line left and right chest, and anteriorly at the midclavicular line left and right chest (figure 1)
- For any abnormalities detected, the area should be investigated more by sliding the probe along the rib space or changing the probe to a transverse view to scan in-between the ribs.
Figure 1: Scanning technique for pneumonia