Point-of-care Ultrasound Skills Research Articles

Survey on the use of point-of-care ultrasound detection in 300 emergency departments of tertiary hospital in China in 2018

To investigate the possession of ultrasound equipment and use of point-of-care ultrasound (POCUS) in emergency department of tertiary hospitals in China to figure out the present condition of POCUS in the emergency department. Questionnaire survey was performed through the internet, which included equipment possession, usage, and the sterile technique of the probe in the emergency department of tertiary hospitals. Between September and December in 2018, a total of 2 994 questionnaires link was clicked, and 718 survey responses were collected. After removing duplicated and non-tertiary hospitals questionnaires, the final questionnaire survey covered 300 tertiary hospitals, of which 250 were tertiary A hospitals (83.3%). The number of emergency department which own bedside ultrasound machine was 173 (57.7%), 40.6% (122) of the departments had only one ultrasonic machine. The main sources of equipment were new bought machines (119, 68.8%), given (38, 22.0%) or rented old machines from the ultrasound department (42, 24.3%). None of the emergency physicians in 92 (30.7%) departments mastered the POCUS skills, and 52.7% of the response hospital had less than a quarter emergency physicians grasp the skills. Fees of the POCUS could be charged in 52 (30.1%) of them. The main methods to clean or sterilize the probes were to wipe the probe by cleaning dry paper (97, 56.1%), sterile wet paper (69, 39.9%) or special probe disinfector (23, 13.3%), and used probe protective sleeve and sterile gel (12, 6.9%) as necessary; 79 (45.7%) departments had no conventional probe disinfection measures. When the ultrasonic was used to guide the punctures, the prevention of infection policies were the sterile gloves and saline (106, 61.3%), disposable probe protective sleeve and sterile gel (55, 31.8%). The propagation of POCUS in emergency department is needed to develop in tertiary hospitals in China. The right way to clean the probes need to be emphasized.

Antenatal Point-of-Care Ultrasound (PoCUS) in rural and remote Australian communities: an evaluation of training

Introduction Access to health services, including antenatal ultrasound scanning, is a key risk factor associated with neonatal and maternal mortality and morbidity. Proportionately fewer pregnant women in rural and remote Australia have access to timely ultrasound services compared to women in metropolitan and regional areas, due in part to a chronic shortage of trained sonographers1,2,3. PoCUS is receiving growing attention and offers a practical solution to address this deficit in best practice care. However, questions remain surrounding how to best teach PoCUS and ensure training is contextually delivered to our remotely located clinicians who face considerable barriers to professional development. Objective This research aimed to deliver PoCUS training to small groups of GPs and midwives recruited from rural and remote areas in Australia. The effectiveness of the teaching and experiences of the trainees were examined and the impact of the training on clinical practice explored. Methods Two intensive two-day antenatal PoCUS training workshops (endorsed by ASUM and ISUOG) were conducted for twelve GPs and thirteen midwives in early 2018. They consisted of lectures and practical hands-on sessions with high fidelity simulators and live pregnant models. Pre- and post-training assessment and evaluation was conducted and progress surveyed at 3 and 6 months. The Kirkpatrick Evaluation Framework (KEF) was used to appraise the efficacy of the PoCUS training provided. Results All participants found the training useful and relevant to their role, and highly rated the workshop design, content and delivery. The advantages of High fidelity simulators and live pregnant volunteers featured heavily in the feedback. Pre/post testing analysis showed 26% improvement in antenatal US knowledge (P Conclusion PoCUS presents a viable solution to assist resource-poor settings in rural and remote Australia. Intensive workshops are able to equip clinicians with valuable life-saving skills which can benefit our most disadvantaged communities. Geographical isolation and lack of onsite specialist supervision poses an ongoing challenge to the development of remote trainees’ PoCUS skills.

Structured, Small-group Hands-on Teaching Sessions Improve Pre-clerk Knowledge and Confidence in Point-of-care Ultrasound Use and Interpretation.

IntroductionMany undergraduate medical education (UME) programs have begun adopting point-of-care ultrasound (PoCUS) curricula, reflecting the increasing ubiquity of this technique across medical specialties. The structures of international PoCUS curricula have been extensively studied. However, the efficacy of these curricula to increase knowledge and confidence in PoCUS is less well-studied. We investigated whether a structured, small-group PoCUS teaching session consisting of pre-defined learning objectives, an introductory presentation, and a mandatory hands-on scanning component would increase pre-clerk knowledge of and confidence in PoCUS theory, use, and interpretation.MethodsA pre-post study was designed to assess changes in pre-clerk knowledge and confidence in PoCUS theory, use, and interpretation. Pre-clerks were recruited from the Hamilton campus of the Michael G. DeGroote School of Medicine at McMaster University. Pre-clerks were organized into four groups, with an average group size of seven learners. Two preceptors each taught two groups. Sessions included an introductory PowerPoint presentation and one-on-one preceptor-guided practice in identifying abdominal and genitourinary structures using PoCUS. Student responses on pre- and post-intervention surveys were analyzed to identify changes in knowledge and confidence. Student satisfaction with the teaching session was assessed from self-reported levels of agreement with satisfaction statements. The strengths and areas of improvement for the teaching sessions were identified from open-ended survey responses.ResultsData from 27 students indicated a significant improvement in knowledge test scores (p < .05), with no significant differences between groups (F(3,23) = 0.64, p = n.s.) or between students with different preceptors (p = n.s.). Students’ confidence in PoCUS use and interpretation improved significantly (p < .05 for both), with no significant differences between groups (F(3,23) = 0.70, p = n.s. and F(3,23) = 0.32, p = n.s., respectively) or between students with different preceptors (p = n.s. for both). Improvements in knowledge of and confidence in PoCUS use were significantly correlated (r = .44, p < .05). All of the students agreed that they liked the instruction, content, and structure of the teaching session. The most frequently cited strengths of the teaching sessions were the mandatory individual practice time per student, individualized instruction from and interactions with preceptors, and the small group structure of the sessions.ConclusionThis study provides novel evidence that a structured, small-group teaching session featuring a didactic presentation, defined learning objectives, and mandatory hands-on learning can effectively teach introductory PoCUS knowledge and skills to pre-clerks and increase student confidence. Future studies will investigate the retention and application of PoCUS knowledge and skill throughout clerkship and early residency training to determine if this teaching model can facilitate longitudinal PoCUS learning and competency as well as improved diagnostic capabilities as students advance through undergraduate medical training.

Point of care ultrasound training for internal medicine: a Canadian multi-centre learner needs assessment study

BackgroundSignificant gaps currently exist in the Canadian internal medicine point-of-care ultrasound (POCUS) curriculum. From a learner’s perspective, it remains unknown what key POCUS skills should be prioritized. This needs assessment study seeks to establish educational priorities for POCUS for internal medicine residents at five Canadian residency training programs.MethodsAll internal medicine trainees [postgraduate year (PGY) 1–5] from five internal medicine residency training programs in Canada (n = 598) were invited to complete an online survey on 15 diagnostic POCUS applications, 9 bedside procedures, and 18 POCUS knowledge items. For POCUS applications and procedures, participants were asked how applicable they are to patient care in internal medicine and the participants’ reported skills in those domains. Self-reported knowledge and skills were rated on a 5-point Likert scale, where 1 = very poor and 5 = very good. Applicability was rated, where 1 = not at all applicable and 5 = very applicable.ResultsA total of 253 of 598 residents (42%) participated in our study. Data from one centre (n = 15) was removed because of low response rate (15%) and significant baseline differences between those trainees and the remaining participants. Of the remaining analyzable data from four training programs (n = 238), participants reported highest applicability to internal medicine for the following applications and procedures: identifying ascites/free fluid [mean applicability score of 4.9 ± standard deviation (SD) 0.4]; gross left ventricular function (mean 4.8 ± SD 0.5) and pericardial effusion (mean 4.7 ± SD 0.5); thoracentesis (mean score 4.9 ± SD 0.3), central line insertion (mean 4.9 ± SD 0.3), and paracentesis (mean 4.9 ± SD 0.3), respectively. Overall reported knowledge/skills was low, with skill gaps being the highest for identifying deep vein thrombosis (mean gap 2.7 ± SD 1.1), right ventricular strain (mean 2.7 ± SD 1.1), and gross left ventricular function (mean 2.7 ± SD 1.0).ConclusionsMany POCUS applications and procedures were felt to be applicable to the practice of internal medicine. Significant skill gaps exist in the four Canadian training programs included in the study. POCUS curriculum development efforts should target training based on these perceived skill gaps.

Assessing a novel point-of-care ultrasound training program for rural healthcare providers in Kenya

BackgroundA novel point-of-care ultrasound (PoCUS) training program was developed to train rural healthcare providers in Kenya on the Focused Assessment with Sonography for Trauma (FAST), thoracic ultrasound, basic echocardiography, and focused obstetric ultrasonography. The program includes a multimedia manual, pre-course testing, 1-day hands-on training, post-testing, 3-month post-course evaluation, and scheduled refresher training. This study evaluates the impact of the course on PoCUS knowledge and skills. Competency results were compared based on number of previous training/refresher sessions and time elapsed since prior training.MethodsTrainees were evaluated using a computer-based, 30 question, multiple-choice test, a standardized observed structured clinical exam (OSCE), and a survey on their ultrasound use over the previous 3 months.ResultsThirty-three trainees were evaluated at 21 different facilities. All trainees completed the written exam, and 32 completed the OSCE. Nine trainees out of 33 (27.3%) passed the written test. Trainees with two or more prior training sessions had statistically significant increases in their written test scores, while those with only one prior training session maintained their test scores. Time elapsed since last training was not associated with statistically significant differences in mean written test scores. Mean image quality scores (95% confidence interval) were 2.65 (2.37–2.93) for FAST, 2.41 (2.03–2.78) for thoracic, 2.22 (1.89–2.55) for cardiac, and 2.95 (2.67–3.24) for obstetric exams. There was a trend towards increased mean image quality scores with increases in the number of prior training sessions, and a trend towards decreased image quality with increased time elapsed since previous training. Forty percent of trainees reported performing more than 20 scans in the previous 3 months, while 22% reported less than 10 scans in the previous 3 months. Second and third trimester focused obstetric ultrasound was the most frequently performed scan type. Frequency of scanning was positively correlated with written test scores and image quality scores.ConclusionThis novel training program has the potential to improve PoCUS knowledge and skills amongst rural healthcare providers in Kenya. There is an ongoing need to increase refresher/re-training opportunities and to enhance frequency of scanning in order to improve PoCUS competency.

Point-of-Care Ultrasound Needs Assessment, Curriculum Design, and Curriculum Assessment in a Large Academic Internal Medicine Residency Program.

Internal medicine (IM) residency point-of-care ultrasound (POCUS) curricula are being developed but often are limited in scope or components. In this article, we discuss the demonstration of a need for POCUS training in our large academic IM residency program; the development of a longitudinal curriculum; and the impact of the curriculum on POCUS knowledge, use, and confidence. In 2014, we designed a cross-sectional POCUS survey and knowledge test for all IM residents at the University of California, San Francisco. The results of this assessment drove the design of a longitudinal POCUS curriculum that included a 2-hour workshop for all IM interns and a 1-month elective offered to all IM residents. Residents were tested on their POCUS knowledge and image interpretation before the elective and were given the same test 6 months after the elective. The posttest included a survey of self-reported POCUS use and confidence. In the needs assessment, residents scored a mean of 27% on the knowledge test, and across all applications the percentage of residents reporting confidence in their POCUS skills was lower than the percentage reporting use of the application in clinical practice. Residents scored a mean of 37% on the elective pretest and 74% on the posttest, an increase of 37% (95% confidence interval 31.6-42.8, P < 0.001), with improvements seen across all applications. After the elective, self-reported use of POCUS and confidence in POCUS skills were increased for the applications, using the needs assessment as an approximate baseline. For core cardiac and pulmonary applications, 76% to 95% of residents, depending on application, reported "high" or "very high" use and 79% to 100% reported "high" or "very high" confidence in their POCUS skills. We used a needs assessment to guide the development of a longitudinal, multidisciplinary POCUS curriculum. Residents who completed all components showed substantial long-term gains in knowledge in all major applications and high use of and confidence in cardiac and pulmonary applications.

Acquiring and maintaining point-of-care ultrasound (POCUS) competence for anesthesiologists.

Point-of-care ultrasound (POCUS) involves the bedside use of ultrasound to answer specific diagnostic questions and to assess real-time physiologic responses to treatment. Although POCUS has become a well-established resource for emergency and critical care physicians, anesthesiologists are still working to obtain POCUS skills and to incorporate them into routine practice. This review defines the benefits of POCUS to anesthesia practice, identifies challenges to establishing POCUS in routine anesthesia care, and offers solutions to help guide its incorporation going forward. Benefits to POCUS include improving the sensitivity and specificity of the physical examination and helping to guide patient treatment. The challenges to establishing POCUS as a standard in anesthesia practice include developing and maintaining competence. There is a need to develop standards of practice and a common language between specialties to facilitate training and create guidelines regarding patient management. Presently, our specialty requires consensus by expert stakeholders to address issues of competence, certification, development of standards and terminology, and the management of unexpected diagnoses. To promote POCUS competency in our discipline, we support its incorporation into anesthesiology curricula and training programs and the continuing professional development of POCUS-related activities at a national level.

Point-of-care ultrasound education to improve care of dialysis patients.

Point-of-care ultrasound (POCUS) is rapidly emerging as a bedside diagnostic tool that can enhance physical diagnosis and facilitate clinical decision making. Although ultrasound is widely used by nephrologists for vascular access and kidney imaging, diagnostic POCUS skills in other anatomic areas are not part of routine nephrology training. In this narrative review, we will provide an overview of selected POCUS techniques, highlight potential uses of POCUS in routine nephrology practice, and describe a new curriculum implemented at Johns Hopkins University School of Medicine to teach diagnostic POCUS skills to nephrology fellows.

Pediatric Emergency Medicine Physicians' Use of Point-of-care Ultrasound and Barriers to Implementation: A Regional Pilot Study.

Point-of-care ultrasound (POCUS) has been identified as a critical skill for pediatric emergency medicine (PEM) physicians. The purpose of this study was to profile the current status of PEM POCUS in pediatric emergency departments (EDs). An electronic survey was distributed to PEM fellows and attending physicians at four major pediatric academic health centers. The 24-item questionnaire covered professional demographics, POCUS experience and proficiency, and barriers to the use of POCUS in pediatric EDs. We used descriptive and inferential statistics to profile respondent's PEM POCUS experience and proficiency and Rasch analysis to evaluate barriers to implementation. Our return rate was 92.8% (128/138). Respondents were attending physicians (68%) and fellows (28%). Most completed pediatric residencies prior to PEM fellowship (83.6%). Almost all had some form of ultrasound education (113/128, 88.3%). Approximately half (46.9%) completed a formal ultrasound curriculum. More than half (53.2%) said their ultrasound education was pediatric-specific. Most participants (67%) rated their POCUS proficiency low (Levels 1-2), while rating proficiency in other professional competencies (procedures 52%, emergency stabilization 70%) high (Levels 4-5). There were statistically significant differences in POCUS proficiency between those with formal versus informal ultrasound education (p < 0.001) and those from pediatric versus emergency medicine residencies (p < 0.05). Participants identified both personal barriers discomfort with POCUS skills (76.7%), insufficient educational time to learn POCUS (65%), and negative impact of POCUS on efficiency (58.5%)-and institutional barriers to the use of ultrasound-consultants will not use ultrasound findings from the ED (60%); insufficient mentoring (64.7%), and POCUS not being a departmental priority (57%). While POCUS utilization continues to grow in PEM, significant barriers to full implementation still persist. One significant barrier relates to the need for dedicated time to learn and practice POCUS to achieve sufficient levels of proficiency for use in practice.

Teaching bedside ultrasound to medical students.

Point-of-care ultrasound (POCUS) assists in the rapid diagnosis of conditions in the Emergency Department (ED). POCUS has been introduced to international medical curricula; however, there is no described implementation of clinically focused POCUS education in Australian medical schools. We wanted to investigate whether a formal curriculum can be effective and feasible in an Australian medical school. Pre-post intervention study of a focused curriculum based on the Extended Focused Assessment with Sonography in Trauma (E-FAST) examination, consisting of online and practical teaching, was implemented for Year-4 and -5 medical students. An online questionnaire was used to measure knowledge, image interpretation and confidence prior to the intervention. After the intervention and ED placement, the questionnaire was repeated and students were assessed performing the E-FAST examination on a healthy volunteer. Twenty-seven students participated in both the pre-intervention and post-intervention questionnaires. There was a significant improvement in confidence in performing the E-FAST after the intervention [p<0.001]. There was also a significant improvement in ultrasound knowledge and image interpretation skills. For the formative assessment, the mean score was 31.8 out of 33 and 22 of 27 students (82%) passed the assessment. There is no described implementation of clinically focused point-of-care ultrasound education in Australian medical schools CONCLUSIONS: We have demonstrated that a focused curriculum can improve POCUS knowledge and skills. The curriculum was feasible and well received. With global trends to include POCUS in medical education, Australian institutions should consider upskilling their medical graduates.

Point-of-care ultrasound as a competency for general internists: a survey of internal medicine training programs in Canada

Point-of-care ultrasound (POCUS) is increasingly used on General Internal Medicine (GIM) inpatient services, creating a need for defined competencies and formalized training. We evaluated the extent of training in POCUS and the clinical use of POCUS among Canadian GIM residency programs. Internal Medicine trainees and GIM Faculty at the University of Toronto were surveyed on their clinical use of POCUS and the extent of their training. We separately surveyed Canadian IM Program Directors and Division Directors on the extent of POCUS training in their programs, barriers in the implementation of POCUS curricula, and recommendations for POCUS competencies in IM. A majority of IM trainees (90/118, 76%) and GIM Faculty (15/29, 52%) used POCUS clinically. However, the vast majority of resident (111/117, 95%) and GIM Faculty (18/28, 64%) had received limited training. Of the Program Leaders surveyed, half (9/17, 53%) reported POCUS clinical use by their trainees; however only one quarter (4/16, 25%) reported offering formal curricula. Most respondents agreed that POCUS training should be incorporated into IM residency curricula, specifically for procedural guidance. A considerable discrepancy exists between the clinical use of POCUS and the extent of formal training among Canadian IM residents and GIM Faculty. We propose that formalized POCUS training should be incorporated into IM residency programs, GIM fellowships, and Faculty development sessions, and identify POCUS skills that could be incorporated into future IM curricula.

LO098: Education innovation: implementing a point-of-care ultrasound curriculum for emergency medicine residents

Introduction / Innovation Concept: Point-of-care ultrasound (POCUS) is becoming standard of care in Canadian emergency departments. However, its integration in Emergency Medicine (EM) residency training is poorly studied. If a four-week curriculum can successfully teach POCUS skills to residents, this program could have potential application across specialties and across Canada. Methods: A four-week curriculum was designed, implemented, and evaluated. EM residents registered for the Introductory Ultrasound Rotation at Sunnybrook Health Sciences Centre were invited to participate. Curriculum evaluation included resident feedback, pre-rotation and post-rotation knowledge and skill testing, and a delayed post-rotation survey. Comparison of pre-test and post-test scores were calculated using the paired t-test. Curriculum, Tool, or Material: Residents were scheduled for both dedicated ultrasound scanning shifts and clinical shifts with an emphasis on POCUS in patient care. Residents also reviewed the Canadian Emergency Ultrasound Society Emergency Department Echo DVD and manual, completed weekly readings and assignments, and completed a “clinical encounter worksheet” describing how POCUS impacted clinical care in a patient encounter. Other rotation activities included Ultrasound Rounds where residents presented a critical appraisal of a POCUS-related journal article, Pediatric Ultrasound Rounds at The Hospital for Sick Children, and an advanced POCUS workshop day. Of 13 eligible residents, 12 (92%) completed at least one study assessment. However, only 8 residents (62%) completed both the pre-test and post-test, 8 residents (62%) completed the end-of-rotation survey, and even fewer residents (42%) completed the delayed post-rotation survey. Residents felt the quality of the ultrasound rotation was excellent (mean score 4.7 on 5-point Likert scale). There was an increase in test scores from a baseline of 51.5% to 70.8% on the post-rotation test (p=0.02). Three months after the rotation, 100% of residents reported feeling either comfortable or extremely comfortable teaching and using the core POCUS topics covered in the curriculum. All residents reported that they would recommend the rotation to their colleagues without hesitation. All residents passed the national ultrasound certification examination at the end of the rotation. Conclusion: A four-week curriculum was effective in teaching EM residents POCUS skills. Further study is required to determine the ideal method for teaching POCUS skills in this group.

A majority of rural emergency departments in the province of Quebec use point-of-care ultrasound: a cross-sectional survey.

BackgroundPoint-of-care ultrasound (POCUS) can be used to provide rapid answers to specific and potentially life-threatening clinical questions, and to improve the safety of procedures. The rate of POCUS access and use in Canada is unclear. The objective of this study was to examine access to POCUS and potential barriers/facilitators to its use among rural physicians in Quebec.MethodsThis descriptive cross-sectional study used an online survey. The 30-item questionnaire is an adapted and translated version of a questionnaire used in a prior survey conducted in rural Ontario, Canada. The questionnaire was pre-tested for clarity and relevance. The survey was sent to non-locum physicians working either full- or part-time in rural emergency departments (EDs) (n = 206). All EDs were located in rural and small towns and provided 24/7 medical coverage with acute care hospitalization beds.ResultsIn total, 108 surveys were completed (participation rate = 52.4 %). Of the individuals who completed surveys, ninety-three percent were family physicians, and seven percent had Canadian College of Family Physicians – Emergency Medicine (CCFP-EM) certification. The median number of years of practice was seven. A bedside ultrasound device was available in 95 % of rural EDs; 75.9 % of physicians reported using POCUS on a regular basis. The most common indications for POCUS use were to rule out abdominal aortic aneurysm (70.4 %) and to evaluate presence of free fluid in trauma and intrauterine pregnancy (60 %). The most common reason (73 %) for not using POCUS was limited access to POCUS training programs. Over 40 % of POCUS users received training in POCUS during medical school or residency. Sixty-four percent received training from the Canadian Emergency Ultrasound Society, 13 % received training from the Canadian Association of Emergency Physicians, and 23 % were trained in another course. Finally, 95 % of respondents reported that POCUS skills are essential for rural ED practice.ConclusionsPOCUS use in rural EDs in the province of Quebec appears to be relatively widespread. Access to training programs is a barrier to greater use.

Equipping non-radiologist with basic point of care ultrasound skills- it can save lives!

Background The author serves in a resource limited and logistically challenging rural district hospital in the state of Sarawak, Malaysia. Transfer of patients requiring higher level of care to our nearest referral centre can only be done with 3 hours of boat ride or 1 hour by helicopter. Subspecialty centres, like our cardiac centres, are located even further away and can only be reached directly by helicopter service. We recently encountered a case of a patient admitted into our ward diagnosed to have an acute onset of cardiac tamponade via point of care ultrasound (POCUS) performed by the author, a non-radiologist. Including the author, only 2 out of 10 medical officers in our hospital receive formal training in delivering POCUS. This case report serves to emphasise on the training, utility and benefits of POCUS to frontliners serving in austere working environment.

Teaching Point of Care Ultrasound Skills in Medical School: Keeping Radiology in the Driver's Seat

Ultrasound is used increasingly in medical practice as a tool for focused bedside diagnosis and technical assistance during procedures. Widespread availability of small portable units has put this technology into the hands of many physicians and medical students who lack dedicated training, leaving the education and introduction of this key modality increasingly to physicians from other specialties. We developed a radiology-led program to teach ultrasound skills to preclinical medical students. To develop this new ultrasound program we 1) established a program leader, 2) developed teaching materials, 3) created a hands-on interactive program, and 4) recruited the necessary instructors. The program was piloted with the first-year medical student class of 154 students. The introductory session was assessed by pre- and post-activity Likert scale-based surveys. Of 154 (68.8%) students, 106 completed a voluntary online survey before starting the program and 145 students (94.2%) completed a voluntary survey after the session. Students found the program educationally valuable (4.64 of 5) and reported that it improved their understanding of ultrasound imaging (4.7 of 5). Students' reported confidence in identifying abdominal organs, intra-abdominal fluid, and Morison pouch that was significantly higher on the postactivity survey compared to the presurvey (P < .001 for all). We piloted a radiology-led program to teach ultrasound skills to preclinical medical students. Students found the experience enjoyable and educationally valuable.

My Patient is Short of Breath: Is the Problem in the Lung Tissue?

Undifferentiated dyspnoea is a common patient presentation in the intensive care unit, medical and surgical floors, and in the emergency department. Physical examination and chest radiography are notoriously insensitive for detection and differentiation of various lung pathologies while computed tomography consumes significant resources and exposes the patient to ionizing radiation. Point-of-care ultrasound (PoCUS) is a highly sensitive and specific diagnostic tool that, with appropriate operator experience, is capable of diagnosing and differentiating between the various causes of dyspnoea. PoCUS machines are readily available, images are rapidly generated and repeatable, and technical skills are easily taught during short training sessions. Furthermore, the development of PoCUS skills in one specific area enables and enhances the development of skills in other non-related areas. This article describes the benefits, technical aspects, and challenges associated with using PoCUS to examine the lung parenchyma in the acutely dyspnoeic patient.