Medical Blog｜Fundamentals and Three Key Principles of Lung Ultrasound in Pulmonary Scanning

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Lung ultrasound (LUS) plays a crucial role in modern medical diagnostics, serving as an essential tool in emergency medicine, critical care, and general clinical assessments. Compared to traditional chest X-rays and CT scans, handheld ultrasound offers significant advantages, including radiation-free imaging, portability, real-time visualization, and high sensitivity. It is widely used for the diagnosis and monitoring of pneumonia, pulmonary edema, pneumothorax, pleural effusion, and acute respiratory distress syndrome (ARDS). 

Fundamentals of Lung Ultrasound 

Unlike traditional abdominal or cardiac ultrasound, lung ultrasound operates on different diagnostic principles. Since the lungs are air-filled, ultrasound waves cannot directly penetrate lung tissue. Instead, diagnosis relies on pleural-lung interface reflections, acoustic artifacts, and dynamic changes. 

Key imaging features observed include A-lines, B-lines, lung sliding, lung point, and pleural effusion, allowing physicians to quickly differentiate between normal lungs, interstitial lung disease, pulmonary edema, pneumothorax, and pneumonia, providing an immediate diagnostic reference. 

(Related Reading: Medical Blog | From Costal Cartilage to Pleura: How Handheld Ultrasound Help in Chest Scanning) 

Key Emergency Response Steps 

  1. Normal lungs are filled with air 
  2. Normal pleura has a smooth surface 
  3. Normal pleura moves with respiration (lung sliding) 

Clinical Applications of Lung Ultrasound 

Emergency & Critical Care 

Quick assessment of pneumothorax, pneumonia, pulmonary edema, and ARDS, identifying causes of respiratory failure and monitoring lung condition changes. 

Respiratory Infections & Pneumonia Diagnosis 

Useful for the rapid assessment of COVID-19, bacterial pneumonia, and tuberculosis. 

Pneumothorax & Pleural Effusion Diagnosis 

Traditional chest X-rays may fail to detect small pneumothorax, while ultrasound can immediately identify abnormal lung sliding and lung point, accurately evaluating pleural effusion presence and volume, assisting in drainage treatment decisions. 

Cardiopulmonary Function Assessment 

Combining lung ultrasound with cardiac ultrasound (POCUS) allows for the assessment of congestive heart failure (CHF) and monitoring pulmonary edema or post-cardiac surgery lung changes. 

Case Study: Using Handheld Ultrasound for Pleural Effusion 

A 68-year-old patient was admitted to the ICU due to respiratory distress caused by pneumonia. A chest X-ray (CXR) showed left lower lung infiltration with pleural effusion. However, ICU patients often have limited mobility, making it difficult to reposition them for imaging, and ultrasound machines typically need to be borrowed from other departments.

At this point, the doctor used the Apache neo C62 handheld ultrasound probe for an immediate bedside scan, revealing a significant accumulation of pleural effusion in the lower left lung.

By applying the probe between the ribs, pleural effusion was clearly visualized. After positioning the patient and confirming with ultrasound guidance, a drainage procedure was performed, significantly reducing the pleural effusion and relieving the patient’s respiratory distress. This quick and accurate approach ensured the patient received timely and effective medical care.

(References data: POCUS for pigtail insertion guidance) 

Advantages of Handheld Ultrasound in Pulmonary Scanning 

As seen in the case study, hospital ultrasound machines are often shared among multiple departments, leading to potential delays. Handheld ultrasound devices like the Apache neo C62 eliminate this issue, requiring only a smartphone or tablet with the Apache APP to perform on-the-spot scanning at the patient’s bedside, with no need to wait for scheduling. 

For emergency and ICU patients, handheld ultrasound provides instant imaging, reduces diagnostic delays, and significantly enhances clinical efficiency and flexibility. 

(Related Reading: Apache neo C62 Handheld Wireless Ultrasound) 

 

 

References data 
<The Basic Principles of Lung Ultrasound> 
<Lung Ultrasound: The Essentials> 
<Lung Ultrasound for Critically Ill Patients>