Look into the patients eyes
Do not ignore physical examination of your patient. It's interesting. For example, today's case: about 70 years old male, CABG procedure. What symptom do you see? Answer is under the spoiler )
ANSWER:
Lung Ultrasound & the BLUE Protocol: The New "Visual" Stethoscope for Anesthesiologists
In the high-stakes environment of the OR and the ICU, time is the ultimate variable. When a patient develops acute respiratory failure, waiting for a portable X-ray or transporting a hemodynamically unstable patient to CT can be risky, if not impossible. Enter the BLUE Protocol (Bedside Lung Ultrasound in Emergency) . Developed by Professor Daniel Lichtenstein, this diagnostic algorithm allows an anesthesiologist to identify the cause of dyspnea with over 90% accuracy in under 3 minutes. What is the BLUE Protocol? The BLUE Protocol is a standardized ultrasound algorithm designed for the rapid differential diagnosis of acute respiratory distress. By focusing on specific artifacts rather than traditional imaging, it provides immediate clinical answers. Standardized Scanning: The BLUE-Points To ensure reproducibility—much like the six leads of an ECG—the BLUE-protocol utilizes six standardized points (three on each side) that maximize lung coverage while avoiding the heart:
