B Lines on Lung POCUS B lines are indicative of pulmonary edema. A

A-Lines vs B-Lines on Lung POCUS A-Lines: • Predominately horizontal lines • A-lines are repeated horizontal & parallel lines which are equidistant from the pleura. Commonly seen in dry lungs, asthma, COPD and also a pneumothorax. B-Lines • Predominately vertical lines • B-lines are vertical lines that come from the pleura, extend to the bottom of the screen and move with respirations. 3 or more B-lines in a region is considered pathologic. Commonly seen in pulmonary edema, ARDS, pneumonia and other pathology. - MCW EM Ultrasound @MCW_EM_US #ALines #BLines #Lung #POCUS #pulmonary #clinical #comparison

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Lung POCUS with multiple B-lines representing pulmonary edema Eric Abrams, MD @eabramsMD #Edema #BLines #Lung #POCUS #clinical #Pulmonary #ultrasound

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B-Lines on Lung POCUS PE is LEAST likely to show B lines. Juxtaposition of fluid droplets & air—>multiple foci of reverb artifacts (B-lines) that extend to bottom of screen. Multiple B lines on US (alveolar interstitial syndrome “AIS”) incl ddx pulm edema, pna, ARDS, contusion, & fibrosis #BLines #Lung #POCUS #clinical #Pulmonary #ultrasound

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B-Lines of Pulmonary Edema on Lung POCUS Patient presenting with shortness of breath secondary to viral cardiomyopathy #BLines #Pulmonary #Edema #Lung #POCUS #clinical

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B-Lines on Lung Point of Care Ultrasound (POCUS) ... Stethoscope: [Oh, sounds like wheezing. Let's give nebs!] Ultrasound: [You idiot, can't you see the B lines!?] - Dr. Dan Kim @dan___kim #BLines #POCUS #Clinical #Pulmonary #Lung #Ultrasound

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Normal horizontal repetitive artifacts (A Lines) - Dustin Morrow MD @SonoSerious #ALines #Artifact #Pulmonary #Lung #Ultrasound #POCUS #Clinical #Normal

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Subpleural Consolidations that can be seen in COVID-19 (note this patient did not have COVID-19) Note also how the broadened line also creates B-lines that eradicate the horizontal A-line. ʇɟıɥsI̍CͨMͫpɐɹɐd @PARADicmSHIFT #Subpleural #Consolidations #COVID19 #clinical #lung #ultrasound #pulmonary #BLines #POCUS

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Bilateral B-Lines in case of Pneumonia on Lung POCUS Young healthy pt with fever/dyspnea. POCUS lung exam done. States has bilat B profile with lung sliding-must be pulm edema not PNA according to Blue Protocol, right? No PMH, immunosuppression, travel hx, home meds. No smoking or vaping. Progressive URI over 7-10 days. Differential Bilat B lines/lung sliding: Pulmonary edema, ARDS, interstitial lung disease, interstitial diffuse infections. This patient had Mycoplasma pneumonia. Lung POCUS shows a lot of B lines bilaterally. Also has partially seen shred sign Rt Zone 1. Lung POCUS invaluable but need to know how to apply. Bilateral B-lines DOES NOT definitively diagnose Pulm Edema. - Dr. Robert Jones @RJonesSonoEM #BLines #Bilateral #Pneumonia #Lung #POCUS #clinical #ultrasound

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Lung POCUS: Irregular, thickened pleural line with diffuse B-lines and subpleural consolidation. Seen in viral (including COVID19) and bacterial pneumonia. Curvilinear probe used. Dr. Robert Jones @RJonesSonoEM #BLines #Viral #Pneumonia #Lung #POCUS #Pulmonary #Ultrasound #Clinical

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Lung POCUS: Irregular pleural line with patchy B-lines. Seen in viral (including COVID19) and bacterial pneumonia. This patient had mycoplasma pneumonia. Linear probe used. Dr. Robert Jones @RJonesSonoEM #BLines #Viral #Pneumonia #Lung #POCUS #Pulmonary #Ultrasound #Clinical

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