UMEM Educational Pearls

Category: Administration

Title: Using M-Mode for Lung Ultrasound

Keywords: POCUS, Lung Ultrasound, Pneumothorax (PubMed Search)

Posted: 5/29/2023 by Alexis Salerno, MD
Click here to contact Alexis Salerno, MD

We hope that you enjoy your Memorial Day!

Don't forget your Sandy Beach Sign vs Barcode Sign of Lung Ultrasound:

Normal lung will have good pleural sliding. When you image the lung with M-Mode it looks like a Sandy Beach. 

 

 

 

 

 

 

 

 

 

 

 

A lung with a pneumothorax will have poor lung sliding. When you image the lung with M-Mode it looks like a classic barcode or "stratosphere sign."

Make sure that you are on "Lung Mode" or decrease the gain to better image the movement of the pleural line. The negative predictive value for lung sliding on ultrasound is 99%. This means that if you see lung sliding you do not have a pneumothorax in that area. However, lung sliding is affected by certain conditions such as blebs, pulmonary fibrosis, pleural adhesions and right mainstem intubation. So, like any other radiology study, clinically correlate! 

Thinking about placing a chest tube or have a patient with multiple rib fractures? Take a look at how to perform a Serratus Anteror Plane Block here: https://www.thepocusatlas.com/thoracoabdominal-blocks#Serratus

 

References

Husain LF, Hagopian L, Wayman D, Baker WE, Carmody KA. Sonographic diagnosis of pneumothorax. J Emerg Trauma Shock. 2012 Jan;5(1):76-81. doi: 10.4103/0974-2700.93116. PMID: 22416161; PMCID: PMC3299161.