All sonographers performing TFAST should focus on learning the Big 3 – described in this FASTvet Blog. See the FASTVet Video Library for many examples of Dry Lung, Wet Lung and Pneumothorax and the Search for the Lung Point.
Fig. 1: The is the first finding of the Big 3 at the Chest Tube Site in Trauma ruling out pneumothorax by the presence of the Glide Sign, A-lines with the to and fro motion of the lung gliding along the chest wall. Lisciandro, JVECC 2011
Fig. 2: Wet Lung is the second major finding to be familiar with at the Chest Tube Site. The to and fro swinging motion of Ultrasound Lung Rockets (also called B-lines) that originate from the lung periphery and extend through the far field obliterating A-lines. These immediately rule out pneumothorax (PTX) and in trauma are lung contusions until proven otherwise. Counting the number over a single intercostal space at each lung region (see Vet BLUE) is a way to semi-quantitate lung contusion severity. Lisciandro, JVECC 2011
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