You’re asked to review a patient with dyspnoea and a wheeze.
Does he have pulmonary odema or an exacerbation of COPD? Is there a pneumonia? Could he have a pneumothroax?
Right, lets get an ECG and a CXR, some troponins and, for completeness (Oh how I dislike that as a reason), throw in a BNP for what it’s worth. Now while we’re waiting for all that to happen, we’ll start him on some salbutamol nebs, give him a bolus of frusemide and get some antibiotics into him to cover for community acquired pneumonia. Is the CXR guy on his way yet? Damn, what if he has a PE? Better get a CTPA too.
Or, we could do a bedside lung ultrasound, decide what the patient actually has in the next 2 or 3 minutes and tailor the therapy to the problem.
If the second option sounds appealing, stop what you are doing and go to Matt Dawson and Mike Mallin’s Ultrasound Podcast site right know and watch this video on the basics of lung ultrasound, given by ultrasound guru Mike Stone. It is probably one of the best and most concise talks I have seen on the topic. No acronyms, no crazy technical language, just what to do, what to look for and what it means.
Once you have watched it, you can scroll through the boys’ other podcasts for the evidence of why we should be doing this quick, informative and practical bedside study more often; whether you are working in the ICU, the ED, prehospital or even in theatre. And if you are feeling powerful in ‘the way of the probe’, why not enter the SonoWars competition at SMACC and test your skills against other Sonomurai.
Wnat more on lung ultrasound? Check these out: