1. Lung Ultrasound Indications and Pre-Exam Preparation

Ultrasound Machine Preparation

A common question that comes up is “What ultrasound probe is used for lung ultrasound?” In general, using a curvilinear probe or phased array probe will be just fine. However, if you really want to see the more shallow pleura then you may need to switch to the linear probe.

  • Transducer: Curvilinear Ultrasound Probe or Phased Array Probe.
    • The linear transducer may be used for shallow imaging to scan the pleura close to the chest wall.
  • Preset: Lung or Abdominal
  • Machine Placement: Place the machine on the patient’s right side so you can scan with your right hand and manipulate ultrasound buttons with your left hand.
Lung ultrasound machine and patient positioning
1. Lung Ultrasound Indications and Pre-Exam Preparation

Lung Ultrasound Pre-Exam Preparation

Patient Preparation

  • Patient position: the patient may lie supine, lateral decubitus, or sit erect. For this post, we will be having the patient in the supine position.
  • If you’re scanning the right lung, you will ask the patient to lift their right arm and place their hand behind their head, and vice versa for the left lung.
Lung Ultrasound Patient Positioning - Supine
Supine with Arm Raised
Lung Ultrasound Patient Positioning - Upright
1. Lung Ultrasound Indications and Pre-Exam Preparation

The Lung Ultrasound Indications

Lung ultrasound can be used when you are assessing for:

  • Shortness of breath
  • Pneumonia or other recurring infections
  • Cardiogenic pulmonary edema
  • Acute Respiratory Distress Syndrome (ARDS)
  • COPD/Asthma
  • Pneumothorax

The major limitations of lung ultrasound are:

  • Subcutaneous emphysema: ultrasound waves can’t pass through the air in the skin to evaluate the lungs
  • Patient body habitus: may be difficult to see the lung in severely obese patients.