SonoTip&Trick: “I can’t tell if there is normal lung sliding.” Here’s a quick tip….

All of us have had that case where we had a thoracic trauma victim or an acutely short of breath patient who we want to evaluate for pneumothorax. We use the ultrasound machine since it’s quick and more accurate than chest XRay. We place the linear probe on the anterior chest wall, indicator toward the head at the 2nd intercostal space and midclavicular line, and see this:

SonoTip&Trick: There’s a left pneumothorax! Really? check again…

Whenever you are performing an E-FAST exam on your trauma patient or a thoracic US in those with unexplained shock or shortness of breath, your sphincter tightens when you see fluid in the belly or when there is no lung sliding. Ever placed your probe on the left anterior chest wall and have been surprised after noticing there is no lung sliding? Or, that you see this weird movement of “the lung” on the left side, which surely isn’t normal and definitely deeper than the pleural line and you think, “There’s a left pneumothorax!” Well, guess what guys and gals, it just could be the heart.