![]() ![]() ![]() Trauma may subject the patient to forces causing significant chest wall contusions and hematomas, especially if rib fractures occur, severing the intercostal vessels. The 9 to 12-MHz linear-array probe is ideal for the initial exam of the chest wall because it provides detailed images of the structure of the underlying soft tissues. Initial evaluation of the thoracic cavity involves identification of its surrounding borders including the thoracic wall (subcutaneous tissues, musculature, and ribs), the inferior border of the diaphragm, the liver, spleen, the heart and its major vessels. ![]() This activity reviews the indications, contraindications, and technique involved in performing thoracic ultrasound and highlights the role of the interprofessional team in the care of patients undergoing this procedure. Non-traumatic uses for thoracic ultrasound include evaluation for pleural effusions, infections such as pneumonia or empyema, pulmonary edema, chronic obstructive pulmonary disease, pulmonary embolism, and acute respiratory distress syndrome. Following trauma, thoracic ultrasound can assist with diagnosing pneumothorax, hemothorax, rib fractures, pulmonary contusions, and chest wall hematomas. Studies have shown equivalent or even improved sensitivity and specificity of POCUS compared with conventional chest radiography, and bedside ultrasounds may aid in differentiating between pathologies that conventional radiographs cannot. This is in part because ultrasound equipment is available in many settings, more training programs are educating trainees on point of care ultrasound (POCUS), and ultrasound can be done rapidly without exposure to radiation or contrast. Thoracic ultrasound has rapidly gained popularity over the past 10 years. ![]()
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