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The 8 zone protocol divides each hemithorax into 4 zones – anterior/lateral and upper/lower (See image below). The Image below shows an 8 zone protocol, each hemithorax is divided into 4 zones.

Image: PSL – Parasternal Line, AAL – Anterior Axillary Line, PAL – Posterior Axillary Line.

Lung ultrasound protocol
Lung Ultrasound 8, 12 and 6 zone protocol

Image Ref: I-AIM (Indication, Acquisition, Interpretation, Medical Decision-making) Framework for Point of Care Lung Ultrasound. Anesthesiology. 2017

Image From: Modified Lung Ultrasound Score in Evaluating the Severity of Covid-19 Pneumonia. Sumbul et al. Ultasound in Medicine and Biology. 2021

The 12 zone protocol divides each hemithorax into 6 zones – anterior/lateral/posterior and upper/lower (See image above),

The 6 zone protocol is useful in emergencies:

  • Anterior zone to evaluate for pneumothorax
  • Lateral zones for interstitial fluid
  • Lower zones for pleural effusions