The routine investigation for patient presenting to ER & Critical Care with acute pulmonary condition is CXR. Many a time, its inconclussive and the findings appears late in the course of the disease. Lung ultra sonography has been a current trend in the diagnosing of life threatening pulmonary conditions. The Blue Protocol is been widely used to differentiate them. In our study we have demonstrated that lung ultra sonography with CXR has definitely augmented and improved the specificity, sensitivity as well as the accuracy. This reliable, bedside, rapid non invasive technique can also be utilized in areas where X ray is not possible like in a pre hospital setup (Ambulances/Air ambulances and in pregnant women where there is concern regarding exposure to unwarranted radiation.In the near future ,managing a acute patient without the help of ultrasonography will be considered obsolete and can lead to medico-legal implication.The WINFOCUS GROUP led by PROF LUCA NERI , ENRICO STORTI, DANIEL LICHTENSTEIN , GABRIEL VIA are leading the world in proporgating this effort when previously the lung was considered as an artifact enemy of the ultrasound.