March 30, 2020
Written by: Trisha Reo, RDMS, RVT
Bedside lung ultrasound is being recommended for all patients who present to the ED with flu-like symptoms for the early diagnosis and management of COVID-19 pneumonia. Lung ultrasound is highly sensitive and specific and considered as an alternative to chest radiography or CT scanning. It is performed in a matter of minutes and can be done at the bedside, minimizing the need to move the patient to various areas of the ED, therefore reducing the risk of exposure and spread of this highly infectious virus.
As pneumonia progresses through stages, the appearance on ultrasound will vary depending on the degree and extent of consolidation.
Fluid filled alveoli surrounded by air-filled lung creates short path reverberation artifact, which we call B-lines. A localized patch of numerous B-lines suggests early pneumonia.
As the pneumonia progresses to the next stage, purulent fluid fills the alveoli and the lung takes on a more solid appearance on ultrasound, similar to the appearance of the liver.
It is important to note that atelectasis also results in a solid, non-aerated lung and differentiating the two can be difficult. In pneumonia, the inflammatory process can cause the lung volume to increase while in atelectasis, the alveoli are collapsed and the long volume is reduced. A sonographic finding of atelectasis is scalloped pleural borders as the pleura are pulled in toward the collapsed lung.
Now, more than ever, we are seeing how point-of-care ultrasound can drastically improve patient care and outcomes. All of us at Gulfcoast Ultrasound Institute are committed to providing the educational resources medical professionals need. That is why we are featuring a three-part live stream webinar series focused on point-of-care ultrasound applications. This series includes Lung Ultrasound, Focused Cardiac Ultrasound and RUSH Ultrasound. This series is being offered for free to anyone interested. Visit www.gcus.com or follow our Facebook and Instagram pages for more information.
Stay well out there and thank you for your continued dedication to your patients and our communities during this unprecedented time.
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