Category
Education
Ultrasound
Year
2026
Market
Defense
Introduction
Chemical and biological inhalational exposures create a distinct pulmonary triage problem in military and mass casualty settings. Agent confirmation may be delayed, clinical examination is degraded by personal protective equipment, and conventional imaging may be unavailable, logistically constrained, or insensitive to early pulmonary injury. In this environment, point-of-care lung ultrasound offers something that conventional imaging cannot: a portable, repeatable, non-ionising tool that can be deployed closer to the point of injury.
Point-of-care lung ultrasound
Point-of-care lung ultrasound is a portable, repeatable, non-ionizing imaging modality that can identify the physiologic consequences of inhalational injury, including interstitial syndrome, alveolar-interstitial edema, pleural line abnormality, consolidation, pleural effusion, and pneumothorax in combined blast-inhalational injury.
A proposed operational protocol
In suspected chemical or biological inhalational events, bilateral lung ultrasound could be performed after immediate life threats are addressed and decontamination workflow permits safe device use. A simplified 8- to 12-zone protocol would assess anterior, lateral, and, when feasible, posterior lung zones. Each zone would be scored for A-line predominance, B-line quantity, coalescent B-lines, pleural line abnormality, consolidation, pleural effusion, and lung sliding.Serial scans then become more important than the initial classification.
Conclusion
This approach has potential advantages in triage. It may help identify exposed casualties who require closer observation despite mild symptoms. It may support evacuation prioritization when oxygen, ventilators, transport, or higher-echelon imaging are constrained. It may identify casualties who should receive chest radiography or CT first when those modalities are scarce.
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References
Figures were created specifically for this article series using original illustrations and AI-assisted graphic design tools. Clinical concepts were derived from the references cited in the accompanying text.
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