Lesson 1Standardized views and sequence: lung zones (anterior/lateral/posterior as feasible), cardiac FoCUS, IVC, focused lower-extremity venous examDescribes a practical, reproducible scanning sequence for dyspneic patients, covering anterior, lateral, and posterior lung zones when feasible, followed by focused cardiac views, IVC assessment, and a targeted lower extremity venous exam to streamline 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 dyspneic heart failure patients, using POCUS to rapidly assess hypoxia, pulmonary edema, cardiogenic shock, and thromboembolism, while integrating clinical data to guide triage, stabilization, and escalation of 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 presetsCovers optimization of ultrasound machine settings for lung and cardiac imaging, including depth, gain, harmonics, presets, and image storage, to improve visualization of B-lines, pleural interfaces, cardiac chambers, and IVC dynamics in challenging 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 scansAddresses common limitations and pitfalls in lung–cardiac–venous POCUS, such as noncardiogenic causes of B-lines, body habitus and probe constraints, incomplete venous exams, and cognitive bias, with strategies to reduce false reassurance and misdiagnosis.
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 dyspnea: lung B-lines and pleural effusions, global and regional cardiac function, and IVC and lower extremity venous scanning to detect congestion, right heart strain, and deep vein thrombosis contributing 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 translate POCUS findings into bedside management: titrating diuretics, vasodilators, and noninvasive ventilation, deciding on anticoagulation for suspected DVT or PE, and determining need for ICU admission or urgent cardiology consultation.
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 synthesize lung, cardiac, and venous POCUS patterns to distinguish cardiogenic pulmonary edema from ARDS, pneumonia, and pneumothorax, emphasizing pattern recognition, integration with vitals, and awareness of overlapping presentations.
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 is insufficient and additional imaging or monitoring is required, including indications for chest radiograph, CT pulmonary angiography, formal echocardiography, and invasive hemodynamic assessment in unstable or complex 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 anatomical landmarks and dynamic sonographic signs in lung–cardiac–venous POCUS, including A-lines, B-lines, lung sliding, pleural effusion layering, LV systolic function, and IVC collapsibility, to support rapid, accurate bedside interpretation.
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 selection and rationale for acute dyspnea POCUS, including phased-array for cardiac and IVC, curvilinear for lung and pleura, and linear for DVT and superficial pleural detail, with tips for switching probes efficiently during 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
