Physio-led research paper on lung ultrasound for Covid-19 gains worldwide attention

Three physiotherapists have co-authored a ground-breaking research paper that highlights the use and benefits of using ultrasound imaging in the management of Covid-19 patients.

L-R: Mike Smith, Simon Hayward and Sue Innes

CSP members Mike Smith, Simon Hayward and Sue Innes collaborated with consultant anaesthetist Ashley Miller to produce the paper, titled Point‐of‐care lung ultrasound in patients with Covid‐19 – a narrative review, which was published in the journal Anaesthesia.

Dr Smith, the paper’s lead author and a senior lecturer at Cardiff University, explained the team’s motivations for writing the paper.

‘We quickly collated the early evidence and guidance for use of lung ultrasound in Covid-19 patients, because we wanted to take the information that was flying around the research and clinical communities and make it more useful for clinicians - right at the beginning of the pandemic curve.

‘And since then lung ultrasound has emerged as critical to monitoring lung injury caused by Covid-19.’

Generating global interest


The paper has attracted huge interest around the world, from researchers and clinicians who are keen to find new and more efficient ways of treating Covid-19 patients.

So much so that the, an organisation that analyses the attention research outputs receive online, now ranks the paper’s popularity as being in the top 0.2% of the over 15 million research papers that it has previously tracked.

‘This is a great contribution to physiotherapy and medical practice,’ said Gill Rawlinson, CSP’s assistant director of practice and development.

‘To see three physiotherapists leading in this field, publishing their work in such a prestigious medical journal and achieving such enormous global impact is fantastic, and really demonstrates the impact physiotherapists can make.’

The benefits of using Ultrasound


Simon Hayward, a specialist physio from Blackpool Teaching Hospitals NHS Trust, has been championing the use of lung ultrasound for several years, as well as training respiratory physios and other clinicians to use it.

‘It’s an amazing tool because we can observe the changes in lung damage - and use it to inform how we manage these patients in real time,’ he said.

‘It has the potential to be integrated into care pathways for every Covid-19 patient with lung injury and to monitor their recovery.’

As well as having diagnostic advantages, in comparison to both chest X-rays and CT scans, ultrasound machines are portable, only require on one clinician to operate them and – when it comes to examining the lungs of Covid-19 patients – offer a better tool for infection control.

‘The standard assessment tool - the stethoscope – is riskier to use with Covid-19 patients as it forms a direct connection between the patient's skin and the clinician's face,’ Dr Innes, a senior lecturer at the University of Essex, explains.

‘Lung ultrasound does not carry this risk and the infection control processes needed when using it are relatively straightforward.’

Further guidance to follow

The CSP is now collaborating with the team, and other specialist physios, to produce further guidance for members about the use of ultrasound, in relation to a variety of medical conditions.

‘We are delighted to be working with Mike and the team to develop ultrasound guidance for members so we, as a profession can build on their success and leadership in this developing area,’ said Ms Rawlinson.

Further details about the team’s work will be covered in a future issue of Frontline.

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