A simpler way to read the unstable patient.
EASy is a subcostal-first cardiopulmonary examination — heart, IVC, and lungs on a single probe. Those findings integrate into one hemodynamic phenotype, and the phenotype guides a defined management pathway.
Acquire. Phenotype. Act.
Average examination time, novice sonographers
A protocol that costs a quarter of the time is a protocol that gets repeated when the patient changes.
Fiorini & Basmaji, Can J Anaesth 2022Bedside ultrasound has become essential to critical care, but comprehensive training remains difficult to scale across large clinical workforces.
EASy was built as a structured entry pathway: reliable acquisition first, supervised interpretation second, reproducible bedside decision-making as the endpoint. It begins where a novice can realistically succeed, and it names the point at which a fuller study is required.
Acquire. Phenotype. Act.
Acquire
The cardiac assessment begins with the subcostal window — heart, then IVC — and the same phased-array probe takes the anterior lungs. Additional views are obtained when the focused examination is inadequate or the clinical question remains unanswered.
Phenotype
Heart, IVC, and lung findings are integrated into a single hemodynamic phenotype: cardiac performance, fluid responsiveness, and fluid tolerance read together rather than weighed one at a time.
Act
Each phenotype guides a defined management pathway. This is the step most focused-ultrasound curricula leave to the learner. EASy teaches it explicitly.
Most focused ultrasound training ends at the image. You learn to acquire views and recognize findings — then you're on your own to decide what they mean.
EASy closes that gap. Every EASy examination is designed to reduce uncertainty at the bedside, not merely to describe what was seen: focused findings become a defined hemodynamic phenotype, and the phenotype guides a reproducible management pathway. The findings are deliberately limited — enough to separate the phenotypes that change management, and no more.
That's the difference between learning to scan and learning to manage.
The 6 EASy Views
A systematic bedside exam using only a phased array probe, in a fixed order
Subcostal 4-Chamber
Visualize both ventricles, atria, and valves. Assess global cardiac function.
Acquisition card — freeSubcostal IVC
Assess IVC size and respiratory variation as part of an integrated evaluation of filling state and fluid tolerance.
Acquisition card — freeRight Upper Lung
Assess for A-lines, B-lines, and lung sliding at 2nd intercostal space.
Acquisition card — freeModules are members only — sign in required. The acquisition cards are free, no account needed.
The single cardiac window is a deliberate design choice.
Conventional focused echocardiography often requires mastering several acoustic windows before learners can consistently obtain useful information. EASy begins with one, letting learners focus on acquisition first and supervised interpretation second.
It's the window that most often survives the situations where you need it most — during chest compressions, under drapes, in the ventilated chest. When the subcostal window is unavailable or the focused examination is insufficient, EASy explicitly directs the learner to escalate.
A safer place to start. A bounded exam is a safer exam — but only because the boundaries are explicit and someone is watching. EASy names its own limits: what the examination answers, what it can't, and when to escalate. Every image is saved and reviewed with an experienced physician. The recognized hazard in point-of-care ultrasound has never been too few views; it's been too little oversight. EASy is built around the review loop, not around the shortcut.
The published numbers behind the design
Day one is about acquisition. Focused training on day one targets reliable image acquisition. It does not produce independent interpretation. In a published implementation during the COVID-19 surge, after one day of focused training, novice residents obtained images sufficient for supervised clinical decision-making in 87% of 63 examinations — averaging 4.3 minutes each.
Fast enough to actually use. In the published comparison, novice sonographers completed the EASy assessment in about 4 minutes, against 16 minutes for a full focused transthoracic examination. A protocol that costs a quarter of the time is a protocol that gets repeated when the patient changes.
From there: supervised interpretation at the bedside. Simulation builds the foundation; supervised bedside practice builds competence. EASy is a longitudinal competency pathway — not a one-day claim of independent practice.
10 hemodynamic phenotypes, 4 clusters
Heart, IVC, and lung patterns resolve into one of ten hemodynamic phenotypes, grouped by the dominant cardiac finding. Each supports the next bedside decision. Try it below — then open the full tool to score, classify, and manage a real patient.
Pick the dominant cardiac finding
Both ventricles working well — normal or increased contractility
What you see
Heart: Small cavity, increased contractility
IVC: Flat
Lungs: A pattern (dry) fluid-tolerant
What it means
Hypovolemic shock — findings support marked underfilling.
What to do
Give fluid, and find the source of the loss.
Phenotypes are dynamic. A phenotype names the predominant profile right now — not a fixed diagnosis. EASy is built for the first look and serial reassessment: re-scan when the patient changes.
This is the quick taste
The full EASy MAP tool scores cardiac image quality on the 12-point scale, walks the BP = CO × SVR rule-out worksheet, and returns phenotype-specific management for each of the ten phenotypes.
Print-ready phenotype & resuscitation reference for your ultrasound machines.
What EASy is — and what it isn't
EASy lowers the barrier to bedside hemodynamics. It doesn't raise it.
EASy is
- A handful of subcostal, IVC, and lung views
- Qualitative, 2D pattern recognition
- A path from image to a management decision
- Dynamic — built for serial reassessment
- Learnable in a focused course
EASy is not
- A full echo exam or perfect imaging
- Doppler, strain, or quantitative calculation
- Image acquisition for its own sake
- A one-time snapshot
- A multi-year echocardiography fellowship
Those exclusions are deliberate — they keep EASy reproducible, fast, and usable on the patients who can't wait.
Built on and evaluated through peer-reviewed research
The EASy method, its feasibility in novice hands, and its head-to-head performance against focused transthoracic echocardiography are published — and independently reviewed in editorial and correspondence in Can J Anaesth.
“By simplifying the steps needed to obtain images and extract clinically actionable results, the goal is to broaden the range of clinicians who are able to use POCUS at the bedside.”
— Journal of Visualized Experiments, 2025
Developed by Nibras F. Bughrara, MD, FCCM, FASA
Professor of Anesthesiology & Critical Care Medicine, Vice Chair of Education, and Division Chief of Critical Care at Albany Medical College. EASy is taught with collaborators from Johns Hopkins, Yale, and HSS, and used to train clinicians across North America, Europe, the Middle East, and Asia.
This week's clinical scenario
A real EASy POCUS case to sharpen your phenotyping.
EASy PDA Case 15
74M
74M with a PMH of T2DM, HTN, sleepwalking with multiple falls, presents with complaints of weakness and numbness below nipple line. Patient was found to have severe T6-9 fx with concern for transected spinal cord, dorsal epidural hematoma and right hemothorax, intubated for airway protection.
View the full scenariomembers onlyNot a member? One scenario is free each week — work this week's free case.
One foundation, purpose-built applications
Every clinician starts with EASy MAP, then adds workshops for the scenarios their team meets first.
Plus AI Phenotype — an investigational research project on machine learning for automated phenotype identification (members only). Not intended to replace clinician interpretation.
Train your team to read the unstable patient
Built for the teams who meet shock, airway, and arrest first. Developed and evaluated through peer-reviewed clinical and educational research, and taught internationally through workshops, online courses, and AI-assisted training tools.
Hands-on EASy training
From a one-day fundamentals workshop to train-the-trainer certification — live, case-based courses for clinicians at every level.
Start reading the unstable patient
Learn the EASy approach — the six views, the phenotypes, and the decision — then take the free bedside cards to your ultrasound machine.
Interested in bringing EASy to your institution? Get in touch.
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