POCUS Skills Checklist For Airway Management.pdf

Airway and Lung Ultrasound

These checklists detail learning objectives and assessment criteria for Point-of-Care Ultrasound (POCUS) in two key areas: airway and lung ultrasound.

Airway POCUS:

Indications & Image Acquisition:

Learner must demonstrate understanding of indications for Airway POCUS, including:
Locating the cricothyroid membrane, cricoid cartilage, tracheal rings
Confirming tube placement (nasogastric, endotracheal)
Correctly image structures in sagittal and transverse planes: thyroid cartilage, vocal cords, cricothyroid membrane, cricoid cartilage, hyoid, tracheal rings, esophagus, thyroid gland, surrounding vasculature.

Image Interpretation:

Successfully interpret images to identify:
Cricothyroid membrane
Cricoid cartilage
Tracheal rings

Medical Decision-Making:

Understand and demonstrate appropriate decision-making for emergent cricothyrotomy, cricoid force (pressure), and utilization of oro-/nasogastric tubes.

Lung Ultrasound:

Indications & Limitations/Pitfalls:

Learner must understand indications for lung ultrasound: pneumothorax, effusions/blood, diaphragmatic paresis, interstitial syndrome.
Recognize limitations: previous thoracic surgery, severe pre-existing lung disease, small effusions, ascites, etc.

Image Acquisition & Interpretation:

Identify key structures for pneumothorax: superior/inferior ribs (batwing sign), pleural line.
Image and interpret structures for effusion/blood: diaphragm, anterior chest wall, lung parenchyma.
Assess diaphragmatic movement: mid-axillary line, midclavicular/anterior axillary line.

Specific Interpretations:

Rule out pneumothorax: lung sliding/pulse, vertical artifacts (B-lines, comet tail), seashore sign.
Diagnose pneumothorax: lung point, absence of lung sliding and A-line pattern, barcode sign.
Assess effusion/blood: curtain sign, anechoic collection cephalad to diaphragm, spine sign, sinusoid sign.
Evaluate diaphragmatic function: Δtdi (<20%), excursion (<1.8cm or <4.8cm), paradoxical movement.

Medical Decision-Making:

* Understand appropriate management for pneumothorax: observation vs. needle decompression vs. chest tube vs. pigtail catheter.