Remote guidance and focused point-of-care ultrasound (POCUS) training for cardiopulmonary instability assessment by novice sonographers

Sep 29, 2026

Uploaded by Patrick

Bedside point-of-care ultrasound (POCUS) supports rapid assessment of cardiopulmonary instability, yet expert availability is limited in remote or resource-scarce settings. This study evaluates whether remote guidance and a focused POCUS education enable novice sonographers with minimal experience to acquire sufficient diagnostic-quality images and accurately interpret selected views. Twenty-two volunteers completed image acquisition at baseline, with remote guidance, and after 2-hour training, followed by interpretation of recorded normal and abnormal cases.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Abstract

Objective

Methods

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Materials and methods

R E S U S C I T A T I O N P L U S 2 7 ( 2 0 26) 1011 84 Simulation and education Remote guidance and focused point-of-care ultrasound (POCUS) training for cardiopulmonary instability assessment by novice sonographers Erin Stewarta,b, 1, Timothy T Trana,c, 1, Kenji Tanabea, Amanda Huntd, Gregory Watson d, Alexander Kaizer e, Vikhyat S Bebartaf, Patrick C Ngg,h, 1, Ana Fernandez-Bustamantea,* Abstract Objective: Bedside point-of-care ultrasound (POCUS) is effective to assess patients with cardiopulmonary instability, but experienced personnel is unavailable in secluded locations. We tested whether remote guidance support and a focused POCUS education would allow the acquisition of sufficient diagnostic quality and interpretation of selected cardiopulmonary POCUS views by untrained personnel. Methods: We recruited 22 volunteer adults with little to no POCUS experience. We asked participants to obtain six POCUS heart, lung and abdominal views on healthy volunteers: at baseline; with remote guidance; and independently after a 2-h POCUS training session. Expert sonographers scored the diagnostic image quality (0, 0.5, or 1) . Last, participants interpreted 24 previously recorded POCUS images: 2 normal and 22 abnormal (cardiogenic shock, tamponade, intra-abdominal bleeding, pneumonia, pleural effusion) . Results: The image quality of all six POCUS views at baseline was inadequate for clinical use in >80 % of participants. Image quality of all views improved with remote guidance in >70 % of participants and 2-h training in >50 % of participants. Quality scores improved from baseline with remote guidance in all views, and with training in four views. Lung views had the highest quality improvement. Participants correctly identified as abnormal 72.8 % of images, but only 52.8 % of normal ones. Pneumonia was the condition most correctly identified after training. Conclusions: Remote guidance, better than focused training, allowed novice sonographers to obtain selected POCUS views of sufficient diagnostic quality. Abnormal POCUS images were identified more reliably than normal ones. Education was most effective for acquiring lung POCUS views and pneumonia detection. Keywords: Point-of-care ultrasound (POCUS), Emergency triage, POCUS education, Remote guidance, Cardiopulmonary ultrasound Introduction Point-of-care ultrasound (POCUS) has revolutionized bedside diagnostics and clinical decision-making by enabling real-time acquisition and interpretation of images. With the advent of portable, costeffective, and versatile devices, POCUS is increasingly being integrated into perioperative and critical care practices1–4 as well in resource-scarce settings such as global health, military or rural domestic settings.5,6 For clinicians, its utility extends across a range of applications, including vascular access, airway management, hemodynamic evaluation, and the assessment of cardiopulmonary and abdominal pathology.3,7,8 Over recent decades, POCUS has gained widespread recognition in trauma and acute care, particularly through protocols like the Extended Focused Assessment with Sonography in Trauma (E-FAST) .9,10 These protocols have proven invaluable for rapidly identifying life-threatening conditions such as hemoperitoneum, hemothorax, and pneumothorax, signiﬁcantly inﬂuencing clinical decision-making.9,10 High-quality POCUS that follows standardized guidelines as performed by accredited sonographers, typically in hospital settings, * Corresponding author at: University of Colorado School of Medicine, 12401 E 17th Ave, Leprino bldg, R737, MS B113, Aurora, CO 80045, USA. E-mail address: [ana.fernandez-bustamante@cuanschutz.edu](ana.fernandez-bustamante@cuanschutz.edu) (A. Fernandez-Bustamante) . 1 Present address if different than where the work took place. [https://doi.org/10.1016/j.resplu.2025.101184](https://doi.org/10.1016/j.resplu.2025.101184) Received 5 October 2025; Received in revised form 28 November

FAQs

What was the main objective of the study?

To determine whether remote guidance and focused POCUS education allow untrained personnel to obtain diagnostic-quality cardiopulmonary POCUS images and interpret selected views.

How were participants trained and assessed?

Twenty-two adults with little or no POCUS experience acquired six heart, lung, and abdominal views at baseline, with remote guidance, and after a 2-hour training session. Experts scored image quality and participants interpreted previously recorded POCUS images.

What were the key findings about image quality and interpretation?

Baseline image quality was inadequate for most participants. Remote guidance improved image quality for most views, and 2-hour training improved quality for several views. Participants identified abnormal images more accurately than normal ones, with pneumonia detection strongest after training.

Sep 29, 2026

Uploaded by Patrick