Lesson 1Clinical questions for POCUS in shortness of breath and chest discomfort (eg. pump failure, pericardial effusion, major pneumothorax)This section defines key clinical questions for heart and lung POCUS in breathing difficulties and chest pain, linking symptoms to targetable pathologies such as pump failure, pericardial effusion, and pneumothorax to guide rapid bedside decision-making.
Clarifying the primary dyspnea complaintScreening for pump failure and low outputRuling out major pericardial effusionIdentifying tension or large pneumothoraxPrioritizing life threats vs minor findingsLesson 2Lung scanning zones and views: anterior, lateral, posterior; systematic scanning approachThis section details standardised lung scanning zones and views, including anterior, lateral, and posterior regions, and teaches a systematic, reproducible scanning sequence that minimises missed pathology in acutely dyspneic patients.
Defining anterior lung scanning zonesDefining lateral lung scanning zonesDefining posterior lung scanning zonesStandardized scanning sequence for dyspneaAdapting zones for nonambulatory patientsLesson 3Standard heart windows for focused exams: parasternal long axis, parasternal short axis, apical four-chamber, subxiphoid (subcostal)This section outlines standard heart windows for focused exams, including parasternal long and short axis, apical four-chamber, and subxiphoid views, with emphasis on probe landmarks, orientation, and common pitfalls in dyspneic patients.
Parasternal long axis acquisition stepsParasternal short axis at multiple levelsApical four-chamber view optimizationSubxiphoid cardiac and IVC assessmentCommon artifacts and window pitfallsLesson 4Patient communication and documentation templates for heart and lung POCUS findingsThis section focuses on clear patient communication about POCUS purpose and results, shared decision-making, and structured documentation templates that capture key heart and lung findings, limitations, and follow-up recommendations.
Explaining POCUS purpose to patientsDiscussing preliminary versus final resultsDocumenting key cardiac POCUS elementsDocumenting key lung POCUS elementsStating limitations and follow-up plansLesson 5Clinical decision pathways: how specific POCUS findings alter testing, treatment (diuretics, anticoagulation), disposition, and need for urgent transferThis section demonstrates how specific heart and lung POCUS findings modify diagnostic testing, guide therapies such as diuretics or anticoagulation, influence disposition decisions, and identify patients needing urgent transfer or higher level of care.
POCUS-guided diagnostic test selectionAdjusting diuretics using lung B-linesUsing RV findings to guide anticoagulationDisposition decisions from bedside POCUSCriteria for urgent transfer or escalationLesson 6Limits of focused heart and lung POCUS: image quality factors, differentiating chronic vs acute findings, operator-dependent errors, and when to get formal echo/CT/respiratory consultThis section reviews technical and interpretive limits of focused heart and lung POCUS, including body habitus, artifacts, chronic versus acute changes, operator bias, and clear thresholds for escalating to formal echo, CT, or specialty consultation.
Patient and body habitus image challengesArtifacts that mimic real pathologyDistinguishing chronic from acute findingsCommon operator and interpretation errorsWhen to obtain formal echo or CTTriggers for cardiology or pulmonary consultLesson 7Step-by-step scanning technique: patient positioning, probe placement, imaging planes, depth and gain adjustments for heart and lung windowsThis section provides stepwise guidance for focused heart and lung scanning, including patient positioning, probe placement, imaging planes, depth and gain optimisation, and troubleshooting strategies to improve window acquisition in dyspneic patients.
Optimal positioning for dyspneic patientsProbe orientation and hand ergonomicsSelecting and aligning imaging planesAdjusting depth, gain, and focusTroubleshooting poor acoustic windowsMaintaining patient comfort during scansLesson 8Probe choice and rationale for focused heart and lung examsThis section reviews probe options for focused heart and lung exams, comparing phased array, curvilinear, and linear transducers, and explains how frequency, footprint, and penetration influence image quality and clinical question selection.
Phased array probe indicationsCurvilinear probe strengths and limitsLinear probe uses in lung assessmentBalancing frequency and penetrationMatching probe choice to clinical questionLesson 9Interpretation of focused heart findings: LV systolic function estimates, RV enlargement, pericardial effusion and tamponade physiology, valvular gross abnormalitiesThis section explains how to estimate LV systolic function, recognise RV enlargement and strain, identify pericardial effusion and tamponade physiology, and screen for major valvular abnormalities using focused heart views at the bedside.
Visual estimation of LV systolic functionAssessing RV size and interventricular septumDetecting pericardial effusion and tamponadeScreening for gross valvular abnormalitiesIntegrating cardiac POCUS with vital signsLesson 10Interpretation of lung findings: A-lines, B-lines (diffuse vs focal), lung sliding, consolidation with air bronchograms, pleural effusionThis section covers recognition of normal A-lines, interpretation of B-lines as diffuse or focal, assessment of lung sliding, identification of consolidation with air bronchograms, and characterisation of pleural effusions in the context of acute dyspnea.
Recognizing normal A-line lung patternDifferentiating focal versus diffuse B-linesAssessing lung sliding and pleural lineIdentifying consolidation and air bronchogramsCharacterizing pleural effusion on POCUS
