Clinical decisions at the point-of-care demand that practitioners execute a carefully orchestrated cognitive and technical sequence. Point-of-care ultrasound, as an extension to this clinical exam, can enhance this sequence; it can yield real-time, dynamic, and accurate findings to enable those clinical decisions. But does it always make clinical decisions better or more accurate? While the advantages of point-of-care ultrasound are clear, what is less clear sometimes is how practitioners should wield this tool in the clinical context to both increase diagnostic success and reduce diagnostic error.

​In this tutorial, Dr. Smyth walks us through a challenging case of critical hypoxemia and reviews the vital steps to integrate sonographic findings. He further sheds light on how to think when ultrasound may become the center of attention; or even worse, risks de-centering your attention.  We would like to thank Dr. Leo Smyth, senior trainee in General Internal Medicine, at the University of Alberta for his work.