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    • Home
    • About
    • Knobology
      • What is Ultrasound
      • Cardinal Movements
      • Ultrasound Modes
      • Ultrasound Artifacts
    • Cardiac
      • Basic Cardiac Views
      • LV Function
      • RV Function
      • Basic Valve Assessment
      • Aortic Regurgitation
      • Aortic Stenosis
      • Mitral Regurgitation
      • Tricuspid Regurgitation
    • Lung
      • Lung Assessment
      • Pneumothorax
      • Pneumonia
      • Pleural Effusion
    • Volume
      • JVP
      • IVC
    • Abdomen/Renal
      • FAST Exam
      • Hydronephrosis
    • Advanced
      • Velocity Time Integral
      • LVOT VTI
      • VEXUS
    • GIM Fellows
    • POCUS Selective
    • Contact
  • Home
  • About
  • Knobology
    • What is Ultrasound
    • Cardinal Movements
    • Ultrasound Modes
    • Ultrasound Artifacts
  • Cardiac
    • Basic Cardiac Views
    • LV Function
    • RV Function
    • Basic Valve Assessment
    • Aortic Regurgitation
    • Aortic Stenosis
    • Mitral Regurgitation
    • Tricuspid Regurgitation
  • Lung
    • Lung Assessment
    • Pneumothorax
    • Pneumonia
    • Pleural Effusion
  • Volume
    • JVP
    • IVC
  • Abdomen/Renal
    • FAST Exam
    • Hydronephrosis
  • Advanced
    • Velocity Time Integral
    • LVOT VTI
    • VEXUS
  • GIM Fellows
  • POCUS Selective
  • Contact

Pneumonia

  • POCUS can be a useful tool for the detection of pneumonia.
  • However a full lung assessment can be challenging and time consuming and it can be often challenging to differentiate pneumonia from other lung pathologies. 

Ultrasound Setup

Probe(s): Curvilinear or Phased array

Preset: Lung or abdominal

Position: Position the patient upright, if possible.

Pitfalls: misinterpreting b-lines for pneumonia, misinterpreting atelectasis for pneumonia, not scanning the entire lung fields

Image Acquisition

  • Place curvilinear probe (using abdominal settings) on anterior chest at the clavicle, then scan down to the feet until reach the diaphragm. 
  • Then move laterally across the lung. + continue scanning up the anterior chest until the full lateral chest is covered. 
  • Slide posteriorly and scan the entire posterior lung zone from apex to scapula. 
  • ⚠️ Pneumonia scans involve looking at the entire lung bilaterally, so generally a lot of ultrasound gel is needed to cover the full distance. 


Findings suggestive of pneumonia

Findings suggestive of atelectasis

Findings suggestive of atelectasis

  • Hepatization of the lung = lung looks like liver
  • Dynamic air bronchograms = moving air bronchograms
  • Thick irregular pleural line with B lines (3 or more in a rib space)
  • Note: The above image is from UBC POCUS and shows an irregular thick pleura with B lines: https://www.ubcimpocus.com/lung-gallery/2019/4/22/irregular-pleura-with-blines

Findings suggestive of atelectasis

Findings suggestive of atelectasis

Findings suggestive of atelectasis

  • Static air bronchograms = not moving
  • Note: hepatization can also be seen in atelectasis
  • Check out UBC POCUS's video of a static air bronchogram: https://www.ubcimpocus.com/lung-gallery/2019/4/22/h1lxnj12a5ed5s0ebttv1n8xzeg2vx

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Resources: cpocus.ca, EDE Handbook, UBC POCUS Gallery, POCUS101.com

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