This is another reference list for a talk on ultrasound for emergency cricothyroidotomy given at the fantastic 2019 Critical Care Symposium conference that occurs in Manchester each year. The talk is at the end of the reference list. We’re updating details about our POCUS fellowships too, but until then, please contact us on
Elliott DSJ, Baker PA, Scott MR, Birch CW, Thompson JMD. Accuracy of surface landmark identification for cannula cricothyroidotomy. Anaesthesia. 2010 Sep;65(9):889–94. Weblink
Gadd K, Wills K, Harle R, Terblanche N. Relationship between severe obesity and depth to the cricothyroid membrane in third-trimester non-labouring parturients: a prospective observational study. British journal of anaesthesia. 2018 May;120(5):1033–9. Weblink
Blaivis M, Sama AE. Ultrasonography in the detection of the cricoid membrane for needle cricothyrotomy. Acad Emerg Med 2001;8: 579-80 Weblink
Kristensen MS, Teoh WH, Rudolph SS, Tvede MF, Hesselfeldt R, Børglum J, et al. Structured approach to ultrasound-guided identification of the cricothyroid membrane: a randomized comparison with the palpation method in the morbidly obese. British journal of anaesthesia. 2015 Jun;114(6):1003–4. Weblink
Siddiqui N, Yu E, Boulis S, You-Ten KE. Ultrasound Is Superior to Palpation in Identifying the Cricothyroid Membrane in Subjects with Poorly Defined Neck Landmarks: A Randomized Clinical Trial. Anesthesiology. 2018 Dec;129(6):1132–9. Weblink
This is a reference list for a talk given at the fantastic 2019 Critical Care Symposium conference that occurs in Manchester each year. The talk is at the end of the reference list. We’re updating details about our POCUS fellowships too, but until then, please contact us on
Hansen HC, Helmke K. Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J Neurosurg.; 1997 Jul;87(1):34–40. Weblink
Blaivas M, Theodoro D, Sierzenski PR. Elevated intracranial pressure detected by bedside emergency ultrasonography of the optic nerve sheath. Acad Emerg Med. 2003 Apr;10(4):376–81. Weblink
Ultrasonographic optic nerve sheath diameter to detect increased intracranial pressure in adults:a meta-analysis. Acta radiologica 2019 Feb;60(2):221–9. Weblink
Sargsyan AE, Hamilton DR, Melton SL, Amponsah D, Marshall NE, Dulchavsky SA.Ultrasonic evaluation of pupillary light reflex. Crit Ultrasound J. 2009;1(2):53–7. Webink
Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume.British journal of anaesthesia. 2014 Jul;113(1):12–22. Weblink
Ultrasound for Lower Extremity Deep Venous Thrombosis: Multidisciplinary Recommendations From the Society of Radiologists in Ultrasound Consensus Conference.Circulation 2018 Apr 3;137(14):1505–15. Weblink
Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Aprà F. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Crit Ultrasound J. Springer; 2014;6(1):8. Weblink
A narrative review of diaphragm ultrasound to predict weaning from mechanical ventilation: where are we and where are we heading?Peter Turton, Sondus ALAidarous and Ingeborg Welters The Ultrasound Journal 2019 11:2 Weblink
Vetrugno L, Guadagnin GM, Barbariol F, Langiano N, Zangrillo A, Bove T. Ultrasound Imaging for Diaphragm Dysfunction: A Narrative Literature Review. J Cardiothorac Vasc Anesth. 2019 Jan 4. Weblink
Lung ultrasound in clinical practice: one step forward (G Volpicelli)
Lung ultrasound has been the most impactful new diagnostic tool in the modern emergency medicine during the last 15 – 20 years, together with the advent of troponins… with the difference that lung ultrasound has a wide spectrum of application while troponin has only very few specific
There is a wide differential diagnosis for B lines BUT with clinical history, the differential can be focussed e.g. localised B-lines in the context of a previously healthy young man who just sustained blunt chest trauma.
The re-expansion of a previously atelectatic lung.
The use of lung ultrasound together with echocardiography
Ultrasound whilst very useful does suffer from ideal vs reality difference. Often images obtained in real-life patients and conditions don’t reflect those seen at courses. BUT it is usually good enough.
Bones of thoracic cage
70% of pleura is still visible
Air in lung
Surface imaging techniques
Recommends scanning in 8 sectors (c.f. Lichtenstein’s BLU protocol which utilises 6 points – ref). It does depend on what you are looking for – if pneumonia, make sure you scan the posterior aspects.
Key point 1 – differentiating between air before or beyond the visceral pleura
Key point 2 – No sliding does not equal pneumothorax necessarily. Differential diagnosis includes:
Do you see the lung pulse?
Do you see B-lines? If B-lines are present, there is NO pneumothorax
The position of the lung point in the supine patient gives an idea of the size. If above the anterior axillary line, it is small.
From the pleural line
Spreads without fade
Moves synchronously with lung sliding
Erases horizontal artifacts
Pathological – at least 3 B-lines in longitudinal scan (or at least 3 closely placed B-lines in transverse scan)
Chest radiography and blood tests may be inadequate in the diagnostic process of pleuritic pain. In case of silent CXR, LUS is critical for identifying patients with pleural-pulmonary radio-occult conditions at bedside and cannot be safely replaced by other conventional methods.
Volpicelli et al., 2012
Ultrasound and the airway
Check ETT position – oesophageal intubation and selective intubation