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.

SubIcon Vet BLUE Dry LungFig. 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


SubIcon Vet BLUE Wet Lung


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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