Prehospital lung ultrasound for acute dyspnoea: a narrative mini-review of diagnostic accuracy, feasibility, and B-line-focused training

Lung Ultrasound (LUS) is increasingly used in prehospital emergency care for acute respiratory distress. By identifying artefacts such as B-lines, clinicians can rapidly differentiate “dry” from “wet” lung patterns to guide early treatment, although adoption in the field remains uneven. We conducted a narrative literature review to assess the usefulness of LUS for prehospital evaluation of respiratory distress. A secondary aim was to examine whether focused training on B-line detection improves patient management and limits early symptom progression. Sixteen articles were included. Overall, LUS showed high diagnostic performance for the differential diagnosis of dyspnoea. Using an eight-zone scan, the presence of ≥3 B-lines in at least two thoracic zones reached 94.2% sensitivity and 77.5% specificity for acute heart failure. LUS is rapid, non-invasive, and feasible in the field when performed by trained personnel; targeted education for paramedics and nurses improved diagnostic accuracy and shortened time to therapy in several studies. LUS is a useful, feasible tool for prehospital assessment and early management of acute respiratory distress. Structured theoretical–practical training and protocolised integration of LUS into prehospital pathways are recommended.