Lesson 1Standardized views and sequence: lung zones (anterior/lateral/posterior as feasible), cardiac FoCUS, IVC, focused lower-extremity venous examMaps practical, repeatable scan order for breath-short cases, hitting front, side, back lung areas where possible, then heart views, main vein check, and targeted leg vein scan for smooth flow.
Anterior and lateral lung zone scanning protocolPosterior lung assessment when positioning allowsFocused cardiac views sequence in unstable patientsIVC imaging within the integrated examFocused lower extremity venous compression sequenceLesson 2Clinical priorities for acute dyspnea with heart failure history: hypoxia, pulmonary edema, cardiogenic shock, thromboembolismLists urgent needs in breath-short heart patients, using POCUS to check low oxygen, lung water, pump shock, clots, blending with patient data for sorting, steadying, and stepping up care.
Initial airway, breathing, circulation assessmentPOCUS for rapid hypoxia and shock stratificationIdentifying cardiogenic versus noncardiogenic edemaScreening for right heart strain and thromboembolismRisk stratification and disposition decisionsLesson 3Machine settings for lung and cardiac imaging: depth, harmonics, lung presets, cardiac presetsTweaks machine for lung and heart scans, like depth, gain boosts, wave tricks, presets, storage, to better see water lines, lung surfaces, heart rooms, vein moves in tough cases.
Depth and focus adjustments for lung and pleuraGain, dynamic range, and time-gain compensationUse of harmonics and artifact optimizationSelecting and modifying lung and cardiac presetsImage labeling, clips, and documentation settingsLesson 4Common limitations and pitfalls: B-line etiologies beyond cardiogenic edema, body habitus and probe limitations, false-negative DVT scansTackles usual limits in lung-heart-vein POCUS, like non-heart water line causes, body build and probe issues, partial vein checks, thinking traps, with ways to cut false comfort and wrong calls.
Noncardiogenic causes of diffuse B-linesImpact of obesity and subcutaneous emphysemaRecognizing incomplete or poor-quality venous scansAvoiding overreliance on a single POCUS findingChecklists, second looks, and documentationLesson 5POCUS targets: lung comet-tail B-lines, pleural effusion, cardiac function, IVC and lower extremity DVT scanningSpells key POCUS aims in sudden breathlessness: lung water tails and sac fluid, whole and part heart work, main vein and leg clot checks for fluid buildup, right strain, vein blocks feeding symptoms.
Scanning for comet-tail B-lines and A-line patternsDetection and characterization of pleural effusionsFocused assessment of LV and RV systolic functionIVC size and collapsibility for volume statusLower extremity venous DVT compression protocolLesson 6Management decisions based on findings: diuretics, noninvasive ventilation, vasodilators, need for ICU or cardiology input, anticoagulation for DVT/PE suspicionLinks POCUS to bedside care: dosing water pills, vein openers, mask breathing, clotting meds for leg or lung suspects, and calls for high care or heart team.
Adjusting diuretics based on congestion patternsUsing POCUS to guide noninvasive ventilation useVasodilator and inotrope decisions in shock statesAnticoagulation when DVT or PE is suspectedCriteria for ICU transfer and cardiology inputLesson 7Interpreting POCUS patterns: cardiogenic pulmonary edema vs ARDS vs pneumonia vs pneumothoraxShows blending lung, heart, vein patterns to tell heart lung water from lung injury, lung infection, air leak, stressing pattern spot, vital blends, overlap awareness.
Diffuse B-lines and pleural features in cardiogenic edemaHeterogeneous B-lines and consolidations in ARDSFocal consolidation and dynamic air bronchograms in pneumoniaAbsent lung sliding and lung point in pneumothoraxReconciling discordant lung and cardiac findingsLesson 8When to stop relying on POCUS: need for chest radiograph, CT pulmonary angiography, formal echocardiography, invasive monitoringSets when POCUS alone won't do, needing chest X-ray, lung clot CT, full heart scan, tube checks in shaky or tricky patients.
Red flags requiring immediate CT pulmonary angiographyIndications for formal comprehensive echocardiographyRole of chest radiograph in complex lung findingsWhen to pursue invasive hemodynamic monitoringDocumenting uncertainty and communicating limitsLesson 9Anatomical landmarks and dynamic signs: A-lines vs B-lines, lung sliding, pleural effusion layering, LV systolic function, IVC collapsibilityHits main body markers and live scan signs in lung-heart-vein POCUS, like dry lines vs water tails, lung slide, sac layer, left pump strength, vein squeeze, for quick true reads.
Recognizing A-lines and B-lines in lung windowsAssessing lung sliding and lung pulseIdentifying and grading pleural effusion layeringVisual estimation of LV systolic functionMeasuring IVC diameter and collapsibilityLesson 10Probe choices and rationale: phased-array for cardiac, curvilinear for lung and pleural, linear for DVT and superficial pleural detailPicks probes for breath-short POCUS: phased for heart and vein, curved for lung and sac, straight for clots and surface sac, with switch tips in revival.
Phased-array probe for cardiac and IVC imagingCurvilinear probe for lung and pleural assessmentLinear probe for DVT and superficial pleural detailProbe selection in obese or edematous patientsEfficient probe switching and infection control
