Lesson 1Standardised views and sequence: lung zones (anterior/lateral/posterior as feasible), cardiac FoCUS, IVC, focused lower-extremity venous examOutlines a practical, repeatable scanning order for breathless patients, including anterior, lateral, and posterior lung areas where possible, then focused cardiac views, IVC check, and targeted lower limb venous exam to smooth operations.
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 dyspnoea with heart failure history: hypoxia, pulmonary oedema, cardiogenic shock, thromboembolismSpecifies urgent priorities in breathless heart failure cases, employing POCUS to quickly gauge hypoxia, pulmonary oedema, cardiogenic shock, and thromboembolism, blending clinical data to direct triage, stabilisation, and care escalation.
Initial airway, breathing, circulation assessmentPOCUS for rapid hypoxia and shock stratificationIdentifying cardiogenic versus noncardiogenic oedemaScreening for right heart strain and thromboembolismRisk stratification and disposition decisionsLesson 3Machine settings for lung and cardiac imaging: depth, harmonics, lung presets, cardiac presetsHandles ultrasound machine tweaks for lung and cardiac imaging, such as depth, gain, harmonics, presets, and storage, to better see B-lines, pleural surfaces, cardiac rooms, and IVC movements in tough patients.
Depth and focus adjustments for lung and pleuraGain, dynamic range, and time-gain compensationUse of harmonics and artefact optimisationSelecting and modifying lung and cardiac presetsImage labelling, clips, and documentation settingsLesson 4Common limitations and pitfalls: B-line aetiologies beyond cardiogenic oedema, body habitus and probe limitations, false-negative DVT scansTackles frequent limits and traps in lung-cardiac-venous POCUS, like noncardiogenic B-line causes, body build and probe issues, partial venous checks, and thinking errors, with plans to cut false comfort and wrong diagnosis.
Noncardiogenic causes of diffuse B-linesImpact of obesity and subcutaneous emphysemaRecognising 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 scanningSpecifies main POCUS aims in acute breathlessness: lung B-lines and pleural effusions, overall and local cardiac performance, and IVC plus lower limb venous scanning to spot congestion, right heart stress, and deep vein thrombosis linked to symptoms.
Scanning for comet-tail B-lines and A-line patternsDetection and characterisation 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 suspicionDemonstrates translating POCUS results into bedside handling: adjusting diuretics, vasodilators, and noninvasive ventilation, choosing anticoagulation for possible DVT or PE, and deciding on ICU entry or urgent cardiology advice.
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 oedema vs ARDS vs pneumonia vs pneumothoraxDetails combining lung, cardiac, and venous POCUS patterns to separate cardiogenic pulmonary oedema from ARDS, pneumonia, and pneumothorax, stressing pattern spotting, vital signs blend, and awareness of similar shows.
Diffuse B-lines and pleural features in cardiogenic oedemaHeterogeneous 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 monitoringDefines when POCUS alone isn't enough and extra imaging or monitoring is needed, covering signs for chest radiograph, CT pulmonary angiography, formal echocardiography, and invasive haemodynamic check in unstable or tricky patients.
Red flags requiring immediate CT pulmonary angiographyIndications for formal comprehensive echocardiographyRole of chest radiograph in complex lung findingsWhen to pursue invasive haemodynamic monitoringDocumenting uncertainty and communicating limitsLesson 9Anatomical landmarks and dynamic signs: A-lines vs B-lines, lung sliding, pleural effusion layering, LV systolic function, IVC collapsibilityEmphasises key anatomical landmarks and dynamic ultrasound signs in lung-cardiac-venous POCUS, like A-lines, B-lines, lung sliding, pleural effusion layers, LV systolic performance, and IVC collapsibility, for quick, precise bedside reading.
Recognising 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 detailReviews probe picks and reasons for acute breathlessness POCUS, including phased-array for cardiac and IVC, curvilinear for lung and pleura, and linear for DVT and surface pleural detail, with hints for quick probe swaps in resuscitation.
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 oedematous patientsEfficient probe switching and infection control
