Background: Ultrasound examinations in the critical care setting have been recognized as a 
noninvasive, readily available imaging modality that can complement physical examination and clinical 
evaluation in cases admitted to ICU. Patients and methods: this study is designed to be across 
sectional a study , done on 85 adult patients were admitted to RICU presenting by respiratory failure . 
ultrasonography has been used in two directions firstly as a transthoracic BUS to detect lung disorders 
. The main advantage of transthoracic BUS is its immediate application to the diagnosis of pathology. 
Other advantages include delaying or even avoiding the need for patient transportation to the radiology 
unit, radiation exposure and guiding life-saving therapies in extreme emergency. The other direction 
was assessing the hemodynamic status through IVC and evaluate cardiac function by FOCUS as anon 
cardiologyist. Lung ultrasonography has been used to examine 3 regions at each hemithorax to detect 
lung pathology and counting B –lines. Results our study show significant difference between final 
diagnosis detected by the clinician and that proved by ultrasound . Also proved that Focused cardiac 
ultrasound can be used by non-cardilogist for detection of pericardial effusion. Conclusion: 
ultrasonography is a useful tool in detection of lung pathology and to detect pericardial effusion and to 
assess hemodynamics.