Lesson 1Standardized views and sequence: lung zones (anterior/lateral/posterior as feasible), cardiac FoCUS, IVC, focused lower-extremity venous examDescribes a practical, repeatable scanning order for breathless patients, covering front, side, and back lung zones when possible, then focused cardiac views, IVC check, and targeted lower leg venous exam to smooth workflow.
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, thromboembolismOutlines immediate priorities in breathless heart failure patients, using POCUS to quickly check hypoxia, pulmonary edema, cardiogenic shock, and thromboembolism, blending with clinical data to guide triage, stabilization, and care escalation.
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 presetsCovers tweaks for ultrasound machine settings in lung and cardiac imaging, including depth, gain, harmonics, presets, and storage, to better see B-lines, pleural surfaces, heart chambers, and IVC changes in tough patients.
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 common limits and traps in lung-cardiac-venous POCUS, like non-heart causes of B-lines, body shape and probe issues, incomplete venous checks, and thinking errors, with ways to cut false comfort and wrong diagnoses.
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 scanningDetails key POCUS targets in acute breathlessness: lung B-lines and pleural effusions, overall and local cardiac function, and IVC and lower leg venous scanning to spot congestion, right heart strain, and DVT adding to 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 suspicionShows how to turn POCUS findings into bedside actions: adjusting diuretics, vasodilators, and noninvasive ventilation, deciding on blood thinners for suspected DVT or PE, and knowing when to go to ICU or call cardiology urgently.
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 pneumothoraxExplains how to blend lung, cardiac, and venous POCUS patterns to tell cardiogenic pulmonary edema from ARDS, pneumonia, and pneumothorax, stressing pattern spotting, vital signs integration, and awareness of overlapping looks.
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 monitoringDefines when POCUS alone won't do and more imaging or monitoring is needed, including signs for chest X-ray, CT pulmonary angiography, formal echocardiography, and invasive checks 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 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 collapsibilityFocuses on key body landmarks and moving ultrasound signs in lung-cardiac-venous POCUS, including A-lines, B-lines, lung sliding, pleural effusion layers, LV systolic function, and IVC collapsibility for fast, spot-on bedside 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 detailReviews probe picks and reasons for acute breathlessness POCUS, including phased-array for heart and IVC, curvilinear for lung and pleura, and linear for DVT and surface pleural detail, with tips for quick switches 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 edematous patientsEfficient probe switching and infection control
