Batman Bat-signal (Mega Mini Kits)

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Giovanni Volpicelli, Luciano Cardinale, Giorgio Garofalo, Andrea Veltri. Usefulness of lung ultrasound in the bedside distinction between pulmonary edema and exacerbation of COPD. Emergency Radiology. 15 (3): 145. doi:10.1007/s10140-008-0701-x Bat Metal Wall Art, Flying Bats Metal Wall Decor, Halloween Home Decor, Halloween Gifts, Halloween Outdoor Decor, Bats Bedroom Wall Decor Lichtenstein D: Pleural effusion volume. In Whole Body Ultrasonography in the Critically Ill. Heidelberg, Berlin, New York: Springer-Verlag; 2010:132–133.

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Seen when the margin between the consolidated and aerated lung is an irregular (shredded/fractal) line which is opposed to the lung line ( 4, 7). In the 2006 series 52, The Question alters the traditional Bat-Signal to project a spray-painted question mark. In the One Year Later series, however, with the re-installation of Gordon as commissioner, relations with Batman improve. Upon Batman's return from one year of self-imposed exile, the Bat-Signal is activated once again. The BLUE-protocol combines signs, associates them with a location, resulting in seven profiles (Figure 8). Slater A, Goodwin M, Anderson KE, Gleeson FV. COPD can mimic the appearance of pneumothorax on thoracic ultrasound. (2006) Chest. 129 (3): 545-50. doi:10.1378/chest.129.3.545 - Pubmed In the "Lovers and Madmen" story arc from the 2006 series Batman Confidential, Batman sees the Bat-Signal and assumes Gordon is calling him to ask for his help. When he reaches the rooftop, however, he finds the Joker instead.A. M-mode ultrasound image depicting the sea-shore sign; P indicates the pleural line; B. The stratosphere/barcode sign in which no movement is seen below the pleural line A pneumothorax can be divided into two broad categories: traumatic (including iatrogenic) or atraumatic. Atraumatic pneumothorax can further be categorized as primary spontaneous or secondary spontaneous. Pneumothorax is commonly associated with both blunt and penetrating chest injury and is a leading cause of preventable morbidity and mortality. Traumatic pneumothorax, the most common life-threatening outcome in blunt chest trauma, occurs in over 20% of patients with blunt injuries and about 40% with penetrating chest injuries.[ 2]

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In Detective Comics #466 (1976), the villainous Signalman traps Batman inside the Bat-Signal device. Jardin F, Farcot JC, Boisante L, Curien N, Margairaz A, Bourdarias JP. Influence of positive end-expiratory pressure on left ventricle performance. New Engl J Med. 1981;4(7):387–392. doi: 10.1056/NEJM198102123040703. If lung sliding is not seen anteriorly, the probe should be moved gradually to more lateral and posterior positions on the thoracic wall, searching for the location of the lung point. The more lateral or posterior is the position where it is identified, the larger is the pneumothorax. In the episode "The Cat, the Bat, and the Ugly" of the animated TV series The Batman, Batman has just foiled a plot that The Penguin tried to pull on top of a lighthouse. After talking to Detective Yin, Batman is standing in front of the lighthouse light when the Bat Signal appears in the sky. In the second-season finale, "Night in the City" after newly inducted Commissioner Gordon finally agrees to ally with Batman; he begins using the Bat-Signal. After that, his "Batwave" alarm was rarely used. McGonigal MD, Schwab CW, Kauder DR, Miller WT, Grumbach K: Supplemented emergent chest CT in the management of blunt torso trauma. J Trauma 1990, 30: 1431–1435. 10.1097/00005373-199012000-00001Reissig A, Kroegel C: Transthoracic sonography of diffuse parenchymal lung disease: the role of comet tail artifacts. J Ultrasound Med 2003, 22: 173–180. Desai SR, Hansel DM. Lung imaging in the adult respiratory distress syndrome: current practice and new insights. Intensive Care Med. 1997;4:7–15. doi: 10.1007/s001340050284. Rodriguez, Jeremiah (September 21, 2019). "Bat-Signal cut short in Montreal due to police operation". CTV News.

Lung ultrasound in the critically ill - PubMed

Power slide’ in normal sliding lung. Power (angiography) Doppler is used at the pleural line, which is visualized lighting up with color flow as subtle sliding is detected. The probe must be steady to avoid unwanted color artifacts Lichtenstein D, Mezière G, Biderman P, Gepner A, Barré O: The comet-tail artifact: an ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 1997, 156: 1640–1646. 10.1164/ajrccm.156.5.96-07096 Via G, Lichtenstein D, Mojoli F, Rodi G, Neri L, Storti E, Klersy C, Iotti G, Braschi A: Whole lung lavage: a unique model for ultrasound assessment of lung aeration changes. Intensive Care Med 2010, 36: 999–1007. 10.1007/s00134-010-1834-4 On ultrasound we will see the chest wall, ribs with rib shadows and intercostal spaces. The normal pleural interface is seen as a hyperechoic shimmering line when the patient is breathing. On close observation we can visualize the visceral pleura sliding against the parietal pleura. The parietal pleura is attached to the inner lining of the chest wall. During inspiration and expiration, we can visualize the visceral pleura moving along with the lung surface against the parietal pleura. This is known as lung sliding. Normal aerated lung will show A-lines. A-lines are reverberation artifacts.The B-profile suggests acute hemodynamic pulmonary edema with 97% sensitivity and 95% specificity. The A-profile associated with DVT provides an 81% sensitivity and 99% specificity for pulmonary embolism. The B’-profile, A/B-profile, C-profile, and A-V-PLAPS profile are typical profiles indicating pneumonia. An A-profile without DVT or PLAPS (the nude profile) is likely to be severe asthma or exacerbated COPD. The A’-profile and a lung-point is specific to pneumothorax. A pneumothorax contains air and no fluid, and therefore, will rise to the least dependent area of the chest. In a supine patient this area corresponds to the anterior region of the chest at approximately the second to fourth intercostal spaces in the mid-clavicular line. This location will identify the majority of significant pneumothoraces in the supine patient, which makes it the recommended initial area for investigation in a trauma.[ 17, 18] In contrast, air will accumulate in an apicolateral location in an upright patient.[ 19] Data for using the FALLS-protocol (Fluid Administration Limited by Lung Sonography) have been published, showing the correlation between an A-profile or equivalents (A/B-profile) and a low pulmonary artery occlusion pressure (PAOP), with a 18-mmHg value occurring when B-lines appear [ 46]. Caval vein analysis is associated to the FALLS-protocol, especially in the case of initial B-profile. On the 1992 television show Batman: The Animated Series, the signal is introduced in the episode "The Cape and Cowl Conspiracy", though a makeshift signal was used earlier in " Joker's Favor". In 2004's The Batman, Gordon invents it to summon Batman in "Night in the City", although the signal is also alluded to in an earlier episode.

Bat wing opacities (lungs) | Radiology Reference Article Bat wing opacities (lungs) | Radiology Reference Article

Weinberger SE, Drazen JM: Diagnostic procedures in respiratory diseases. In Harrison’s principles of internal medicine. 16th edition. New York: McGraw-Hill; 2005:1505–1508. Desai SR, Hansel DM: Lung imaging in the adult respiratory distress syndrome: current practice and new insights. Intensive Care Med 1997, 23: 7–15. 10.1007/s001340050284 Maury E, Guglielminotti J, Alzieu M, Guidet B, Offenstadt G: Ultrasonic examination: an alternative to chest radiography after central venous catheter insertion? Am J Respir Crit Care Med 2001, 164: 403–405. 10.1164/ajrccm.164.3.2009042The decision tree below shows how to use lung ultrasound findings to evaluate a patient with acute respiratory failure. If lung sliding is seen in all lung fields bilaterally and three or more B-lines are visible in an intercostal space, it suggests pulmonary edema. The presence of lung sliding in all fields will also rule out the possibility of pneumothorax. A mixed picture with A and B lines is consistent with pneumonia. Even though lung sliding is not observed, the presence of B-lines rules out pneumothorax in the lung zone scanned. Note that B-lines can only be produced through lung tissue. Lung point is consistent with pneumothorax. Always correlate clinically, and do not hesitate to use other imaging options to come to a final diagnosis if in doubt. Lichtenstein D, Goldstein I, Mourgeon E, Cluzel P, Grenier P, Rouby JJ. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome. (2004) Anesthesiology. 100 (1): 9-15. Pubmed