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)