Have you ever experienced the following clinical dilemmas:
- A patient is in resus with shortness of breath and the CXR is inconclusive – maybe a bit of shadowing at the left base (or it could be breast shadow), maybe they have a bit of pulmonary congestion and the heart looks big (it always does in resus). Perhaps you are considering a cocktail of antibiotics, frusemide, fluids, digoxin, nitrates, all stirred with a pericardiocentesis needle (because that heart really does look big). Lung ultrasound can assist
- A CXR looks like a pneumothorax but it might just be a bulla. Lung ultrasound may help.
- The CXR shows significant unilateral opacification and you are not sure how much is due to consolidation and how much is an effusion. It is safe or beneficial to put in a chest drain. Lung ultrasound can assist.
- You are due to retrieve a trauma patient by air and may need fly at altitude. You consider prophylactic chest drains but do not want to delay transfer if it can be avoided. Lung ultrasound can help.
- You have given a litre of iv fluid to a septic patient with a known cardiomyopathy and they remain hypotensive. You are debating when you can give more fluids or whether inotropes are required. Lung ultrasound can help.
This workshop is directed towards the use of lung ultrasound for interstitial syndrome, pneumothorax, consolidation and effusions. Although directed towards practitioners who already understand the basics of point of care ultrasound, novices would also benefit by gaining an insight to the benefits of lung ultrasound and that the skills needed to perform lung ultrasound can be rapidly learned.
Alistair Murray is an Emergency Physician who works in the Lyell McEwin Hospital. He has promised his wife that he will stop his incessant pursuit of ultrasound qualifications, now that he has completed the DDU. He is the current chair of the ACEM Ultrasound Subcommittee.
He also rides a Ducati and makes his own beer.