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Lung   Lung point
Normal breathing in normal lungs. Note the shadow from the ribs and the strong echo from the pleural line. The movement of the two pleural layers against each other creates the caracteristi image of "Lung sliding".   Pneumothorax. Longitudinal scan between two ribs, note the absence of rib-shadows. The strong white line is the strong echo called the pleural line. Observe the pleural line and note the "sliding lung"- coming in from the right side. The tip of this sliding indicates the point where the lung is just in contact with the parietal pleura, = the "Lung point".
Interstitial Syndrome   Intubation confirmation
B-lines are hyperechoic, laser-like, vertical lines originating from the pleura and extending to the bottom of the field of view. B-lines move synchronously with lung sliding. Interstitial syndrome is characterized by more than two B-lines in the intercostal spaces in most or all of the anterior and lateral areas of the chest.    
Localization of trachea and the cricothyroid membrane with ultrasonography  

Ruling out an intra-operative pneumothorax


Identification of the cricothyroid membrane with ultrasonography
Longitudinal "string of pearls" approach


Identification of the cricothyroid membrane with ultrasonography
Transverse "TACA" approach


Read our paper to see how to get a blinking light to guide your way to the trachea when you do flexible videoscopic intubation in patients with difficult airways:

Infrared Red Intubation System (IRRIS) guided flexile videoscope assisted difficult airway management
Kristensen MS, Fried E, Biro P
Acta Anaesthesiologica Scandinavica Oct 24 2017 [Epub ahead of print]





Dept. of Otolaryngology - Head and Neck Surgery and Audiology
Rigshospitalet, University Hospital of Copenhagen

Cricothyroidotomy – the emergency surgical airway
Melchiors J, et al. 
Head Neck 2016;38:1129–31










Longitudinal ultrasound scan of the neck as part of a routine scan to identify the cricothyroid membrane with the ”String of pearls”1, 2 method. The transducer is in the saggital midline over the caudal part of the trachea. The anterior part of the tracheal rings are seen as ”dark pearls on a white string”.  A large pulsating blood-vessel  is seen superficial to the midline of the caudal part of the trachea, cranially to the jugular notch.  
  Rapid-4-step technique  
  Surgical airway using rapid 4-step technique as used and taught at Copenhagen University Hospital Rigshospitalet  
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