@bedsidesono :
Lung Ultrasound been around since 1990s
We are learning lessons from China and Italy, but there is not lots of evidence right now in #COVID19
Information now, may not necessarily hold true in a few months now, but we have to trust the info we have now
Lung Ultrasound been around since 1990s
We are learning lessons from China and Italy, but there is not lots of evidence right now in #COVID19
Information now, may not necessarily hold true in a few months now, but we have to trust the info we have now
There are lots of pathologies that cause B-lines
Be cautious if using as a screening tool.
Findings may include:-
B-lines
Thickened pleura
Skip lesions
Consolidation
Be cautious if using as a screening tool.
Findings may include:-
B-lines
Thickened pleura
Skip lesions
Consolidation
Do not make admission/discharge decisions based purely on Ultrasound.
Look at work of breathing
Oxygen requirement as primary determinants
Look at work of breathing
Oxygen requirement as primary determinants
One potential Ultrasound Triage Algorithm- available on @ButterflyNetInc site butterflynetwork.com/covid-19 
There is also the potential to utilise ultrasound to assess the response to treatment intervention eg; proning, PEEP etc
Once again - all findings MUST be compared with clinical presentation and examination findings
Once again - all findings MUST be compared with clinical presentation and examination findings
@yaletung was working with many mildly symptomatic patients with cold-like symptoms and was taking (CRP?) Samples
The first symptoms he had were Mild cough & Myalgia
They were able to identify the likely source as one of his colleagues/fellows
The first symptoms he had were Mild cough & Myalgia
They were able to identify the likely source as one of his colleagues/fellows
Interestingly, @yaletung ‘s wife experienced symptoms but was denied a test as the test supplies were limited. He then scanned her lungs and identified B-lines and thickened pleura.
On that basis, he has kept her in isolation and treated her with Hydroxychloroquine
On that basis, he has kept her in isolation and treated her with Hydroxychloroquine
@yaletung started scanning his PLAPS (posterolateral alveolar and/or pleural syndrome ) point at base findings were:
A-lines (normal)-> B-Lines -> Thickened pleura - bilaterally
Also noted changes at lateral aspects of chest
His Oxygen saturations never less than 95%
A-lines (normal)-> B-Lines -> Thickened pleura - bilaterally
Also noted changes at lateral aspects of chest
His Oxygen saturations never less than 95%
@bedsidesono notes that the type of pleural effusion detected on Ultrasound is not the type or size of effusion that would be detected on CXR
@yaletung scanned his heart every two days but has not identified any changes (thankfully)
Question for @bedsidesono :-
What should we use to clean probe?
Just because you can image/scan with any technique- doesn’t mean you should- pick the right image and be mindful of PPE use.
Solution with high enough content of bleach or alcohol should be fine - not much data..
What should we use to clean probe?
Just because you can image/scan with any technique- doesn’t mean you should- pick the right image and be mindful of PPE use.
Solution with high enough content of bleach or alcohol should be fine - not much data..
Think about risks of taking machines into rooms with aerosol generation.
Must use sleeve for probe and system. Potential advantage of handheld is that probe and phone will fit into a sleeve.
Balance with risk of sterile protective covers running out like PPE/Ventilators!
Must use sleeve for probe and system. Potential advantage of handheld is that probe and phone will fit into a sleeve.
Balance with risk of sterile protective covers running out like PPE/Ventilators!
You can learn the basics of Lung Ultrasound easily, but key is practising and perfecting skills.
Get learning, get educated with many of free resources out there
Get learning, get educated with many of free resources out there
