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… BLUE-protocol

The BLUE-protocol is an ultrasound approach to the lung, and venous network in appropriate cases, allowing fast diagnosis of acute respiratory failure. It combines signs with locations, yielding 7 specific profiles.

   

Where locate sensor: the BLUE-points
(standards exams points)

Two hands (of the size of that of the patient) are posed thus, starting from the clavicle. The medium of the higher hand determines the upper BLUE-point. Medium of the lower palm, the lower BLUE-point.

 

 

 

Leaving the lower BLUE-point transversely, a line crosses the posterior line axillaire. This crossing, or most subsequently possible, the PLAPS-point defines.

The 7 BLUE-profiles:
- A-profile (pulmonary embolism)
- B-profile (hemodynamic pulmonary edema)
- B'-profile (pneumonia)
- A'-profile (pneumothorax)
- C-profile (pneumonia)
- A/B-profile (pneumonia)
- PLAPS profile (pneumonia following logical order)
The decision tree of the BLUE-protocol

We are waiting the permission of ACCP. Meanwhile, this decisino tree features in the following sources:
- The original article: Relevance of lung ultrasound in the diagnosis of acute respiratory failure. The BLUE-protocol. Chest 2008;134:117-125
- The textbook: Whole Body Ultrasonography in the Critically Ill (Springer, 2010), page 194
- The textbook: L’Echographie Corps Entier chez le patient critique (Springer, 2011), page 186