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Lung ultrasound may be used for the detection of a pneumothorax,

consolidated or atelectectatic lung, pulmonary oedema and pleural
effusions. The ideal probe is a microconvex probe but a cardiac probe
will suffice.

The anterior view to exclude pneumothorax can be found in the second

ICS, mid-clavicular line (Fig 1). The lung base, diaphragm, liver or
spleen are readily imaged with the transducer positioned at the
posterior axillary line at the level of approximately the sixth ICS (Fig
2). The probe marker points cranially, towards the patient's head. The
diaphragm may be identified as a thin, echo-bright structure moving
with respiration.

When the probe is placed in the same orientation on the anterior chest
wall, a bright line is seen between two dark echo-free spaces. This is
called the 'bat sign' (Fig 3 / Fig 4). The bright line is the pleura and the
echo-free spaces are the ribs. The pleura is seen to be moving with
respiration. This is called lung sliding.

If M-mode is activated with the cursor perpendicular to the pleura, the

'seashore sign' is seen (Fig 5). The moving pleura and lung create the
grainy 'beach' and the straight lines above (static soft tissues) create Fig 3 Illustration of 'bat sign'
the 'sea'.

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