Grey scale longitudinal ultrasound scan of the intercostal space showing collapsed lung (arrow) which appears as moving jellyfish on real time sonography. L – liver; PLEF – pleural effusion This sign is seen in pneumothorax and is highly specific for this condition ( 4, 9, 13). The point where the healthy sliding lung meets the absent sliding in pneumothorax is referred to as the lung point. It gives an indication of the size of pneumothorax by its location ( 30). A pneumothorax can be divided into two broad categories: traumatic (including iatrogenic) or atraumatic. Atraumatic pneumothorax can further be categorized as primary spontaneous or secondary spontaneous. Pneumothorax is commonly associated with both blunt and penetrating chest injury and is a leading cause of preventable morbidity and mortality. Traumatic pneumothorax, the most common life-threatening outcome in blunt chest trauma, occurs in over 20% of patients with blunt injuries and about 40% with penetrating chest injuries.[ 2] Lauer MS: Elements of danger - the case of medical imaging. N Engl J Med 2009, 361: 841–843. 10.1056/NEJMp0904735

Lung Ultrasound - European Society of Cardiology

In the 2012 film The Dark Knight Rises, the rusted remains of the destroyed Bat-Signal are still atop police headquarters. However, at the end of the film, with Batman declared dead, Gordon sees a restored Bat-Signal, providing hope that Batman has survived. (The signal itself is never used once in the film, however, making it the only live-action film about Batman where this occurs.) Acute respiratory failure is a life-threatening condition whose cause is sometimes difficult to recognize immediately. Initial mistakes have deleterious consequences [ 41]. The extreme patient’s suffering legitimizes the use of any tool that expedites relief. Reducing the time needed to provide this relief is the aim of the BLUE-protocol. Several other studies highlight the utility of ultrasound compared to CXR for the diagnosis of pneumothorax in the Emergency Department.[ 11– 14] The sensitivity of ultrasound in certain studies has been similar to that found in CT scan, which is still considered to be the gold standard for the detection of a pneumothorax.[ 11, 15] Lichtenstein et al., have shown that ultrasound has a sensitivity of 95.3% and a specificity of 91.1% for detecting pneumothorax in intensive care unit (ICU) patients.[ 16] However, in this particular article, the authors cite that the underlying lung process may have affected the accuracy of ultrasound, resulting in both false-positive and false-negative cases.Lichtenstein D, van Hooland S, Elbers P, Malbrain ML. Lichtenstein D, et al. Anaesthesiol Intensive Ther. 2014 Nov-Dec;46(5):323-35. doi: 10.5603/AIT.2014.0056. Anaesthesiol Intensive Ther. 2014. PMID: 25432552 Review. M-mode and the absence of lung sliding are shown as the ‘stratosphere sign’: Parallel horizontal lines above and below the pleural line, resemble a ‘barcode.’ This sign indicates a pneumothorax at this intercoastal space Lichtenstein D, Mezière G: A lung ultrasound sign allowing bedside distinction between pulmonary edema and COPD: the comet-tail artifact. Intensive Care Med 1998, 24: 1331–1334. 10.1007/s001340050771 van der Werf TS, Zijlstra JG: Ultrasound of the lung: just imagine. Intensive Care Med 2004, 30: 183–184. 10.1007/s00134-003-2083-6 Keep collections to yourself or inspire other shoppers! Keep in mind that anyone can view public collections - they may also appear in recommendations and other places.

British American Tobacco

On the 1992 television show Batman: The Animated Series, the signal is introduced in the episode "The Cape and Cowl Conspiracy", though a makeshift signal was used earlier in " Joker's Favor". In 2004's The Batman, Gordon invents it to summon Batman in "Night in the City", although the signal is also alluded to in an earlier episode.Unexpected limitations (dealt with in our textbook, some apparently futile) can suddenly appear at any step of the management of extreme emergencies, potentialized by the extreme stress. An issue is the permanent risk to face unsuitable cardiac windows. If the user wishes to follow the SESAME-protocol, i.e., assessing here the veins (especially calf areas), the cardiac probe should be urgently replaced by a vascular probe. Time is necessary at each probe change (heart, abdomen, lungs…), setting change, not to forget probe/cable disinfection (here theoretical, usually a critical point). Complex keyboards turn into hindrances to novices. Several probes make cables inextricably mixed. Cables lying on the floor favor the risk of a machine tipover when suddenly mobilized. Problems occur when each of these small difficulties is added to each other. Lichtenstein D: FALLS-protocol. In Whole Body Ultrasonography in the Critically Ill. Heidelberg, Berlin, New York: Springer-Verlag; 2010:223–241. In the finale of the fourth season, " A Dark Knight: No Man's Land", James Gordon has Lucius Fox activate the Floodlight on top of the G.C.P.D building. After the episode, Gordon tells Bruce Wayne that the signal is meant to be a symbol of hope, while both are looking up at the clouds illuminated by the Floodlight.