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You are asked by a colleague to assist in performing a diagnostic tap on a patient with cough, fever and a CXR suggesting a left sided pleural effusion….

You review the patient & percuss the chest to the dullest point.  Instead of ‘poking blindly’ you decide to grab your nearby ultrasound and slap the probe on (left posterior chest wall, longitudinal plane, just below tip of scapula).

This is what you see… Left lower lobe consolidation with a loculated pleural effusion.

Diagnostic aspiration of this is unlikely to be successful & the procedure should be aborted.

  1. Turner JP, Dankoff J. Thoracic ultrasoundEmerg Med Clin North Am. 2012 May;30(2):451-73.

  2. Ultrasound Podcast Episode 31 (Pneumothorax & Pleural Effusion) & Episode 32 (Pneumonia & ARDS)

  3. Sonocloud


Kylie Baker

May 26, 2015 at 8:05 AM If you are being really flash, briefly swap to the straight probe and see if there are any intercostal vessels in your proposed trajectory – suggest a lot of angling and use power doppler rather than colour to find them as they are very small. Go back to the straight probe for the actual procedure.



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