🎞 Diagnostic Media Review — current vs candidate replacements

How to apply a swap: open the Proctor console → 🎞 Media → find the clip → ↺ Replace → pick the candidate file. Candidate files live in 07_Sim_Training_App\static\media_review_assets\. The swap takes effect everywhere the file is used (scenario imaging panels included) and ⎌ restores the original at any time. Nothing is changed until you click Replace.
All candidates are openly licensed (CC — see each card); keep the attribution line with the file if you redistribute. Videos below have controls — press play to judge the cine. GIFs animate inline.

🔥 Priority swaps (5)

Ultrasound Lung US - normal lung sliding

⚠ WEAK TEACHING: M-mode looks barcode-like though labeled "sliding present" — defeats the point (anchors 4 scenarios)

CURRENT

lung sliding.jpeg

quality 3/5 · watermark: small · label match: unsure

M-mode looks stratified/barcode-like, not seashore; poorly differentiates from the no-sliding image

Used in: S1 Running for His Life; S2 No Air; S5 On Fire; S17 Man's Best Friend

CANDIDATE

lung-sliding-normal.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Moving clip replaces static JPEG used as 'sliding present' in S1/S2/S5/S17/S36

Ultrasound POCUS - ONSD elevated ICP

⚠ USER-FLAGGED: current ONSD video is weak — replace with cine + caliper still so trainees can SEE the measurement and call elevated ICP

CURRENT

POCUS_ONSD_measurement.mp4

Used in: S3 Lights Out; S16 The ICP Climb

CANDIDATE

onsd-elevated-icp.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'ONSD for ICP' cine for S3/S16

Ultrasound POCUS - ONSD normal (comparison)

⚠ USER-FLAGGED: current ONSD video is weak — replace with cine + caliper still so trainees can SEE the measurement and call elevated ICP

CURRENT

POCUS_ONSD_measurement.mp4

Used in: S3 Lights Out; S16 The ICP Climb

CANDIDATE

onsd-normal.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Normal ONSD comparison; small GIF (47KB) but valid

Ultrasound POCUS - ONSD measurement technique (still with calipers)

⚠ USER-FLAGGED: current ONSD video is weak — replace with cine + caliper still so trainees can SEE the measurement and call elevated ICP

CURRENT

POCUS_ONSD_measurement.mp4

Used in: S3 Lights Out; S16 The ICP Climb

CANDIDATE

onsd-measurement.webp

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Static caliper-measurement still (WebP, 40KB); pairs with the two cines

Ultrasound POCUS - gastric antrum full stomach (aspiration risk)

⚠ RIGHTS: McGraw-Hill textbook figure with copyright banner — swap before distributing

CURRENT

POCUS_gastric_antrum_full.png

quality 5/5 · watermark: intrusive

published McGraw Hill textbook 4-panel figure (Hung's Difficult Airway) with copyright caption - rights concern

Used in: S2 No Air

CANDIDATE

gastric-antrum-full-stomach.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Full Stomach' antrum cine replaces static PNG (S2)

Candidate upgrades (64)

Ultrasound eFAST RUQ - positive Morrison's pouch

CURRENT

POSITIVE MORRISON POUCH.jpeg

quality 4/5 · watermark: small

clean RUQ view, anechoic stripe hepatorenal space; vendor logo + 'RUQ long' label

Used in: S1 Running for His Life; S7 Gut Check; S24 The Shunt; S25 Too Many, Too Fast …

CANDIDATE

efast-morrisons-pouch-positive.gif

Cine loop (GIF) 'Positive FAST - RUQ - Morison's Pouch'; upgrades current static JPEGs to moving clip — The POCUS Atlas / J. Bowra (thepocusatlas.com), CC BY-NC 4.0

Ultrasound eFAST RUQ - positive Morrison's pouch

CURRENT

positive morrison pouch 2.jpeg

quality 4/5 · watermark: small · label match: unsure

free-fluid stripe subtle/not obvious

Used in: S7 Gut Check

CANDIDATE

efast-morrisons-pouch-positive.gif

Cine loop (GIF) 'Positive FAST - RUQ - Morison's Pouch'; upgrades current static JPEGs to moving clip — The POCUS Atlas / J. Bowra (thepocusatlas.com), CC BY-NC 4.0

Ultrasound eFAST RUQ - positive Morrison's pouch

CURRENT

RUQ +FAST.gif

quality 3/5 · watermark: small

hypoechoic region around liver plausible free fluid; grainy; gif-first-frame-only

Used in: S7 Gut Check

CANDIDATE

efast-morrisons-pouch-positive.gif

Cine loop (GIF) 'Positive FAST - RUQ - Morison's Pouch'; upgrades current static JPEGs to moving clip — The POCUS Atlas / J. Bowra (thepocusatlas.com), CC BY-NC 4.0

Ultrasound eFAST RUQ - positive Morrison's pouch

CURRENT

+FAST in Morrison's Pouch from Splenic Injury.gif

quality 4/5 · watermark: small

anechoic wedge in Morrison pouch visible on first frame; POCUS Atlas logo; gif-first-frame-only

Used in: S35 Triage Bypass

CANDIDATE

efast-morrisons-pouch-positive.gif

Cine loop (GIF) 'Positive FAST - RUQ - Morison's Pouch'; upgrades current static JPEGs to moving clip — The POCUS Atlas / J. Bowra (thepocusatlas.com), CC BY-NC 4.0

Ultrasound eFAST RUQ - free fluid in Morrison's pouch (alternate)

CURRENT

POSITIVE MORRISON POUCH.jpeg

quality 4/5 · watermark: small

clean RUQ view, anechoic stripe hepatorenal space; vendor logo + 'RUQ long' label

Used in: S1 Running for His Life; S7 Gut Check; S24 The Shunt; S25 Too Many, Too Fast …

CANDIDATE

efast-morrisons-pouch-free-fluid.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Second Morrison's pouch clip; use where two distinct positive RUQ views are needed (S7 morrison vs morrison2)

Ultrasound eFAST RUQ - free fluid in Morrison's pouch (alternate)

CURRENT

positive morrison pouch 2.jpeg

quality 4/5 · watermark: small · label match: unsure

free-fluid stripe subtle/not obvious

Used in: S7 Gut Check

CANDIDATE

efast-morrisons-pouch-free-fluid.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Second Morrison's pouch clip; use where two distinct positive RUQ views are needed (S7 morrison vs morrison2)

Ultrasound eFAST suprapubic/pelvic - positive (penetrating trauma)

CURRENT

Suprapubic +FAST from GSW.gif

quality 3/5 · watermark: small · label match: unsure

dark first frame, free fluid hard to appreciate; GE Venue; gif-first-frame-only

Used in: S6 Pelvis Down

CANDIDATE

efast-suprapubic-positive-gsw.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Suprapubic +FAST from GSW' - same case family as current file, full-resolution original

Ultrasound eFAST suprapubic/pelvic - positive (penetrating trauma)

CURRENT

POSITIVE MORRISON POUCH AND PELVIS.jpeg

quality 4/5 · watermark: small · label match: unsure

suprapubic view only despite filename claiming Morrison+pelvis; fluid around bladder visible

Used in: S4 Groin Shot; S4 Groin Shot; S6 Pelvis Down; S7 Gut Check …

CANDIDATE

efast-suprapubic-positive-gsw.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Suprapubic +FAST from GSW' - same case family as current file, full-resolution original

Ultrasound eFAST pelvis transverse - positive free fluid

CURRENT

Pelvic +FAST from Spleen Lac.gif

quality 4/5 · watermark: small

anechoic pelvic collection adjacent to bladder; gif-first-frame-only

Used in: S6 Pelvis Down

CANDIDATE

efast-pelvis-transverse-positive.gif

Clean transverse pelvic free fluid cine — The POCUS Atlas / J. Bowra (thepocusatlas.com), CC BY-NC 4.0

Ultrasound eFAST pelvis transverse - positive free fluid

CURRENT

POSITIVE MORRISON POUCH AND PELVIS.jpeg

quality 4/5 · watermark: small · label match: unsure

suprapubic view only despite filename claiming Morrison+pelvis; fluid around bladder visible

Used in: S4 Groin Shot; S4 Groin Shot; S6 Pelvis Down; S7 Gut Check …

CANDIDATE

efast-pelvis-transverse-positive.gif

Clean transverse pelvic free fluid cine — The POCUS Atlas / J. Bowra (thepocusatlas.com), CC BY-NC 4.0

Ultrasound eFAST LUQ - positive splenorenal recess

CURRENT

positive splenorenal recess.jpeg

quality 3/5 · watermark: small

subtle fluid stripe; dark/grainy

Used in: S7 Gut Check; S35 Triage Bypass

CANDIDATE

efast-luq-splenorenal-positive.gif

Moving LUQ positive FAST replaces static JPEG — The POCUS Atlas / J. Bowra (thepocusatlas.com), CC BY-NC 4.0

Ultrasound Hemoperitoneum - free intraperitoneal blood

CURRENT

Hemoperitoneum.gif

quality 4/5 · watermark: small

bowel loops in free fluid; machine UI menu bar visible; gif-first-frame-only

Used in: S7 Gut Check

CANDIDATE

hemoperitoneum.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Likely the original source of the current file, full resolution

Ultrasound Subcapsular splenic hematoma

CURRENT

Subcapsular Splenic Hematoma.gif

quality 3/5 · watermark: small · label match: unsure

Philips FAST preset; hematoma not clearly delineated on first frame; gif-first-frame-only

Used in: S7 Gut Check

CANDIDATE

subcapsular-splenic-hematoma.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Same-named TPA asset, original quality

Ultrasound Echo subxiphoid - normal, no effusion

CURRENT

Subxiphoid _Subcostal - Normal.gif

quality 4/5 · watermark: small

clean subxiphoid, no effusion; POCUS Atlas logo; gif-first-frame-only

Used in: S1 Running for His Life; S3 Lights Out; S5 On Fire; S8 No Airway …

CANDIDATE

subxiphoid-normal.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Normal subxiphoid cine from eFAST gallery; used in 10+ scenarios

Ultrasound Echo hyperdynamic LV - short axis (kissing walls, hemorrhagic shock)

CURRENT

POCUS_hyperdynamic_kissing_papillary.mp4

Used in: S1 Running for His Life; S9 Running Dry; S18 Man's Best Friend II; S27 Zone I Down

CANDIDATE

hyperdynamic-lv-short-axis.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Hyperdynamic Left Ventricle (Short)' - PSSA kissing-walls appearance for S1/S9/S18/S27

Ultrasound Echo hyperdynamic LV - long axis (alternate view)

CURRENT

POCUS_hyperdynamic_kissing_papillary.mp4

Used in: S1 Running for His Life; S9 Running Dry; S18 Man's Best Friend II; S27 Zone I Down

CANDIDATE

hyperdynamic-lv-long-axis.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Hyperdynamic State (Long)' companion view

Ultrasound Lung US - normal lung sliding

CURRENT

positive lung sliding.mp4

Used in: S2 No Air; S36 The Third Patient

CANDIDATE

lung-sliding-normal.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Moving clip replaces static JPEG used as 'sliding present' in S1/S2/S5/S17/S36

Ultrasound Lung US - absent lung sliding (pneumothorax)

CURRENT

no lung sliding.jpg

quality 4/5 · watermark: small

M-mode barcode/stratosphere pattern consistent; still image

Used in: S2 No Air; S17 Man's Best Friend; S36 The Third Patient; S40 ICU Is the ER

CANDIDATE

lung-sliding-absent-ptx.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'No Lung Sliding' cine replaces static JPEG in S2/S17/S36/S40

Ultrasound Lung US - lung point (pathognomonic PTX)

CURRENT

POCUS_lung_point.mp4

Used in: S2 No Air; S8 No Airway; S27 Zone I Down; S28 Downward Spiral

CANDIDATE

lung-point-ptx.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

High-quality lung point cine, used in S2/S8/S27/S28

Ultrasound Lung US M-mode - barcode/stratosphere sign (PTX)

CURRENT

POCUS_PTX_absent_lung_sliding.mp4

Used in: S2 No Air; S40 ICU Is the ER

CANDIDATE

mmode-barcode-sign-ptx.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Barcode sign M-mode; small file (21KB) but valid 636x454 GIF

Ultrasound Lung US M-mode - seashore vs barcode side-by-side (PTX teaching)

CURRENT

POCUS_PTX_absent_lung_sliding.mp4

Used in: S2 No Air; S40 ICU Is the ER

CANDIDATE

mmode-seashore-vs-barcode-ptx.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Best teaching asset: normal seashore vs barcode comparison in one clip

Ultrasound Lung US - hemothorax (pleural fluid/spine sign)

CURRENT

Hemothorax.gif

quality 3/5 · watermark: small · label match: unsure

first frame dark, spine sign not clearly visible; gif-first-frame-only

Used in: S2 No Air; S28 Downward Spiral

CANDIDATE

hemothorax-lung-us.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Same-named TPA 'Hemothorax' asset, original quality

Ultrasound Lung US - pleural effusion with compressed lung and spine sign (alternate)

CURRENT

Hemothorax.gif

quality 3/5 · watermark: small · label match: unsure

first frame dark, spine sign not clearly visible; gif-first-frame-only

Used in: S2 No Air; S28 Downward Spiral

CANDIDATE

hemothorax-spine-sign.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Explicit spine-sign teaching clip (effusion, not trauma case)

Ultrasound Lung US - B-lines (wet lung/pulmonary edema)

CURRENT

POCUS_B_lines_wet_lung.mp4

Used in: S20 Ground Glass

CANDIDATE

b-lines-pulmonary-edema.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'B-Lines - Pulmonary Edema' cine for S20 ARDS

Ultrasound Lung US - confluent B-lines (alternate, severe)

CURRENT

POCUS_B_lines_wet_lung.mp4

Used in: S20 Ground Glass

CANDIDATE

b-lines-confluent.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Confluent B-lines - more severe pattern option

Ultrasound Lung US - pulmonary contusion

CURRENT

Pulmonary Contusion.gif

quality 3/5 · watermark: small · label match: unsure

GE lung view mostly dark; pleural line visible but contusion/B-lines weak on first frame; gif-first-frame-only

Used in: S20 Ground Glass; S28 Downward Spiral

CANDIDATE

pulmonary-contusion-us.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Same-named TPA asset, original quality (S20/S28)

Ultrasound IVC US - flat/collapsible IVC (hypovolemia)

CURRENT

POCUS_IVC_flat_hypovolemic.mp4

Used in: S9 Running Dry; S38 Dark; S39 The Long Game

CANDIDATE

ivc-flat-hypovolemic.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Inferior Vena Cava in Hypovolemia (Transverse)' for S9/S38/S39

Ultrasound IVC US - flat/collapsible IVC (hypovolemia)

CURRENT

Inferior Vena Cava in Hypovolemia.gif

quality 4/5 · watermark: small · label match: unsure

clean Philips subcostal but IVC collapse is a motion finding, unverifiable on still; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

ivc-flat-hypovolemic.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Inferior Vena Cava in Hypovolemia (Transverse)' for S9/S38/S39

Ultrasound IVC US - plethoric non-collapsible IVC (obstructive shock/RV failure)

CURRENT

POCUS_IVC_plethoric_volume_overload.mp4

Used in: S10 Squeeze Play; S26 Throwing Clots

CANDIDATE

ivc-plethoric-noncollapsible.gif

Plethoric IVC for S10 tamponade / S26 PE — The POCUS Atlas / Jaclyn Walker (thepocusatlas.com), CC BY-NC 4.0

Ultrasound IVC US - plethoric non-collapsible IVC (obstructive shock/RV failure)

CURRENT

Plethoric Inferior Vena Cava.gif

quality 4/5 · watermark: small

dilated IVC at RA junction on Philips subcostal; full plethora assessment needs motion; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

ivc-plethoric-noncollapsible.gif

Plethoric IVC for S10 tamponade / S26 PE — The POCUS Atlas / Jaclyn Walker (thepocusatlas.com), CC BY-NC 4.0

Ultrasound IVC US - normal collapsibility (volume assessment)

CURRENT

POCUS_IVC_collapsibility.mp4

Used in: S20 Ground Glass; S39 The Long Game; S40 ICU Is the ER

CANDIDATE

ivc-normal-collapsibility.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Normal Inferior Vena Cava' longitudinal cine for S20/S39/S40 collapsibility assessment

Ultrasound IVC US - normal collapsibility (volume assessment)

CURRENT

normal Inferior Vena Cava Emptyting into Right Atrium.gif

quality 4/5 · watermark: small

subcostal SX view showing IVC-RA junction, normal caliber; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

ivc-normal-collapsibility.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Normal Inferior Vena Cava' longitudinal cine for S20/S39/S40 collapsibility assessment

Ultrasound Echo - hemopericardium from stab wound

CURRENT

Hemopericardium From a Stab Wound.gif

quality 4/5 · watermark: small

pericardial collection with echogenic clot around heart; UI bar + POCUS Atlas logo; gif-first-frame-only

Used in: S10 Squeeze Play

CANDIDATE

hemopericardium-stab-wound.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Same-named TPA asset, original quality (S10)

Ultrasound Echo - traumatic pericardial tamponade

CURRENT

pericardial tamponade.mp4

Used in: S10 Squeeze Play

CANDIDATE

tamponade-traumatic.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Traumatic Tamponade' - trauma-specific, ideal for S10

Ultrasound Echo - traumatic pericardial tamponade

CURRENT

Pericardial Tamponade.gif

quality 3/5 · watermark: small · label match: unsure

zoomed blurry frame; effusion present but tamponade physiology unassessable on still; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

tamponade-traumatic.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Traumatic Tamponade' - trauma-specific, ideal for S10

Ultrasound Echo - traumatic pericardial tamponade

CURRENT

POCUS diagnosis of hemorrhagic cardiac tamponade.mp4

not referenced by any scenario (media-library extra)

CANDIDATE

tamponade-traumatic.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Traumatic Tamponade' - trauma-specific, ideal for S10

Ultrasound Echo - pericardial tamponade (RUSH/medical, alternate)

CURRENT

pericardial tamponade.mp4

Used in: S10 Squeeze Play

CANDIDATE

tamponade-pericardial.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Pericardial Tamponade' from RUSH gallery; 13MB GIF - consider mp4 conversion

Ultrasound Echo - pericardial tamponade (RUSH/medical, alternate)

CURRENT

Pericardial Tamponade.gif

quality 3/5 · watermark: small · label match: unsure

zoomed blurry frame; effusion present but tamponade physiology unassessable on still; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

tamponade-pericardial.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Pericardial Tamponade' from RUSH gallery; 13MB GIF - consider mp4 conversion

Ultrasound Echo - pericardial effusion without tamponade (PSSA)

CURRENT

Subxiphoid View of Pericardial Effusion.gif

quality 3/5 · watermark: small

effusion stripe visible between liver and heart; small low-res file (~300px); gif-first-frame-only

Used in: S11 Heart of the Matter

CANDIDATE

pericardial-effusion-pssa.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Pericardial and Pleural Effusion In PSSA' for S11 effusion-no-tamponade

Ultrasound Echo - pericardial effusion without tamponade (PSSA)

CURRENT

Pericardial Effusion PSSA.gif

quality 4/5 · watermark: small

Philips PSAX with anechoic pericardial rim visible; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

pericardial-effusion-pssa.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Pericardial and Pleural Effusion In PSSA' for S11 effusion-no-tamponade

Ultrasound Echo - reduced EF / global hypokinesis (PLAX)

CURRENT

Reduced Ejection Fraction (Parasternal Long Axis View).gif

quality 4/5 · watermark: small · label match: unsure

clean GE Venue PLAX but EF unassessable on single frame; gif-first-frame-only

Used in: S11 Heart of the Matter

CANDIDATE

reduced-ef-plax.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'Reduced Ejection Fraction' PLAX cine (S11)

Ultrasound Echo - reduced EF cardiomyopathy (alternate)

CURRENT

Decreased EF (Parasternal Short).gif

quality 4/5 · watermark: small · label match: unsure

Philips PSAX with 2018 date header; EF unassessable on single frame; gif-first-frame-only

Used in: S32 Pump Failure

CANDIDATE

reduced-ef-cardiomyopathy.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'New Onset Cardiomyopathy with Reduced EF' for S32 pump failure; verify view matches PSSA label before swap

Ultrasound Echo - cardiac standstill

CURRENT

Cardiac Standstill.gif

quality 3/5 · watermark: small · label match: unsure

dim blurred frame; standstill is motion finding, unverifiable on still; gif-first-frame-only

Used in: S29 All at Once; S41 Crack the Chest

CANDIDATE

cardiac-standstill.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Same-named TPA asset (S29/S41)

Ultrasound Echo - ventricular fibrillation (fibrillating myocardium, subcostal)

CURRENT

Ventricular Fibrillation.gif

quality 4/5 · watermark: small · label match: unsure

Philips PLAX; VF not assessable on still frame; gif-first-frame-only

Used in: S41 Crack the Chest

CANDIDATE

vfib-subcostal-echo.gif

Subcostal VF after ROSC (S41) — The POCUS Atlas / Robert Jones DO FACEP (thepocusatlas.com), CC BY-NC 4.0

Ultrasound Echo - ventricular fibrillation (fibrillating myocardium, subcostal)

CURRENT

Ventricular Fibrillation1.gif

quality 4/5 · watermark: small · label match: unsure

Philips cardiac view; rhythm not assessable on still frame; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

vfib-subcostal-echo.gif

Subcostal VF after ROSC (S41) — The POCUS Atlas / Robert Jones DO FACEP (thepocusatlas.com), CC BY-NC 4.0

Ultrasound Echo - McConnell's sign (massive PE, A4C)

CURRENT

Apical 4 Chamber view demonstrating massive PE with RV dilation, D-sign, and McConnel sign with clot in transit.gif

quality 4/5 · watermark: small

RV dilated relative to LV on first frame; clot-in-transit not confirmed; gif-first-frame-only

Used in: S26 Throwing Clots

CANDIDATE

mcconnells-sign-pe.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

McConnell's sign A4C cine (S26)

Ultrasound Echo - McConnell's sign (massive PE, A4C)

CURRENT

McConnell's Sign - Pulmonary Embolism.gif

quality 4/5 · watermark: small · label match: unsure

Philips A4C with RV dilation visible; McConnell unverifiable on still frame; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

mcconnells-sign-pe.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

McConnell's sign A4C cine (S26)

Ultrasound Echo - RV thrombus (clot in transit) with McConnell's sign

CURRENT

Apical 4 Chamber view demonstrating massive PE with RV dilation, D-sign, and McConnel sign with clot in transit.gif

quality 4/5 · watermark: small

RV dilated relative to LV on first frame; clot-in-transit not confirmed; gif-first-frame-only

Used in: S26 Throwing Clots

CANDIDATE

rv-thrombus-mcconnells.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Clot-in-transit + McConnell's for S26 massive PE

Ultrasound Echo - RV thrombus (clot in transit) with McConnell's sign

CURRENT

McConnell Sign with RV Enlargement.gif

quality 4/5 · watermark: small · label match: unsure

apical view with dilated RV plausible but McConnell apical-sparing is motion finding; POCUS Atlas logo; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

rv-thrombus-mcconnells.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Clot-in-transit + McConnell's for S26 massive PE

Ultrasound Echo - RV strain with RV dilation and D-sign (PSSA)

CURRENT

RV Strain with RV dilation and D-sign on PSSA.gif

quality 3/5 · watermark: small · label match: unsure

dark Sonosite first frame; D-sign/septal flattening not clearly seen; gif-first-frame-only

Used in: S26 Throwing Clots

CANDIDATE

rv-strain-d-sign-pssa.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Same-named TPA asset, original quality (S26)

Ultrasound Echo - RV strain with RV dilation and D-sign (PSSA)

CURRENT

D Sign in Right Heart Strain.gif

quality 4/5 · watermark: small

GE Venue PSAX with flattened septum/D-shaped LV visible; gif-first-frame-only

not referenced by any scenario (media-library extra)

CANDIDATE

rv-strain-d-sign-pssa.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Same-named TPA asset, original quality (S26)

Ultrasound POCUS - non-compressible common femoral vein (DVT)

CURRENT

FEMORAL VEIN DVT.gif

quality 4/5 · watermark: small

LOGIQ dual-panel short-axis color Doppler + long-axis with intraluminal echogenic clot; labeled panels; gif-first-frame-only

Used in: S26 Throwing Clots

CANDIDATE

dvt-common-femoral-noncompressible.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

'DVT of Left Common Femoral Vein' compression cine (S26)

Ultrasound Soft tissue US - subcutaneous air in necrotizing fasciitis (NSTI)

CURRENT

POCUS_NSTI_soft_tissue_US.mp4

Used in: S23 The Rot; S46 Flesh Eating

CANDIDATE

nsti-subcutaneous-air.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Subcutaneous air with dirty shadowing - pathognomonic NSTI (S23/S46)

Radiology / ECG / TEG Tension pneumothorax (CXR, at presentation)

CURRENT

CXR on presentation Traumatic Tension PTX.png

quality 4/5 · watermark: small · label match: unsure

PTX features present but classic tension signs (shift, depressed diaphragm) not striking

Used in: S2 No Air; S25 Too Many, Too Fast; S29 All at Once; S36 The Third Patient …

CANDIDATE

cxr-tension-pneumothorax-left.jpg

CC BY-SA 4.0 — Hellerhoff, Wikimedia Commons (CC BY-SA 4.0)

2972x1472 AP chest radiograph, left tension pneumothorax with mediastinal shift. High-res, textbook-quality. Scenarios: S2, S25, S29, S36, S40.

Radiology / ECG / TEG Pneumothorax (supine CXR) - deep sulcus sign (alternate/supine presentation)

CURRENT

CXR on presentation Traumatic Tension PTX.png

quality 4/5 · watermark: small · label match: unsure

PTX features present but classic tension signs (shift, depressed diaphragm) not striking

Used in: S2 No Air; S25 Too Many, Too Fast; S29 All at Once; S36 The Third Patient …

CANDIDATE

cxr-deep-sulcus-sign-supine-ptx.jpg

CC BY-SA 4.0 — Hellerhoff, Wikimedia Commons (CC BY-SA 4.0)

1468x1439 supine AP film showing deep sulcus sign - the classic supine-trauma pneumothorax appearance (matches original filename which cites deep sulcus sign).

Radiology / ECG / TEG Hemothorax (CXR)

CURRENT

traumatic HTX.jpg

quality 3/5 · watermark: small

supine diffuse haze consistent; necklace artifact over upper chest

Used in: S28 Downward Spiral; S36 The Third Patient

CANDIDATE

cxr-massive-right-hemothorax.jpg

CC BY 2.0 — Kaul and Paniagua, Wikimedia Commons (CC BY 2.0)

Massive right hemothorax with near-complete opacification. Grayscale, 600x595. Scenarios: S28, S36.

Radiology / ECG / TEG Pneumoperitoneum / free air under diaphragm (upright CXR)

CURRENT

XRAY_pneumoperitoneum_DU.mp4

Used in: S49 Gut Feeling

CANDIDATE

cxr-free-air-under-diaphragm-pneumoperitoneum.png

CC BY-SA 4.0 — Cerevisae, Wikimedia Commons (CC BY-SA 4.0)

1792x1024 upright CXR, free air under left hemidiaphragm (perforated viscus). Replaces a video placeholder with a clean still. Scenario: S49.

Radiology / ECG / TEG ETT right mainstem malposition (CXR)

CURRENT

RIGHT MAIN STEM.jpg

quality 3/5 · watermark: small

left-lung collapse consistent with R mainstem; very low-res 28KB file

Used in: S2 No Air; S8 No Airway

CANDIDATE

cxr-ett-right-mainstem-malposition.jpg

CC BY-SA 4.0 — Hellerhoff, Wikimedia Commons (CC BY-SA 4.0)

1429x1074 AP chest, ETT tip in right main bronchus. Scenarios: S2, S8.

Radiology / ECG / TEG Flail chest / multiple rib fractures with pneumothorax (CXR)

CURRENT

FLAIL CHEST.jpg

quality 3/5 · watermark: small · label match: unsure

displaced rib fractures not conspicuous at this resolution

Used in: S41 Crack the Chest

CANDIDATE

cxr-rib-fractures-pneumothorax.jpg

CC BY-SA 4.0 — James Heilman, MD, Wikimedia Commons (CC BY-SA 4.0)

850x700, right-sided multiple rib fractures + pneumothorax. Closest openly-licensed match to a flail-chest pattern; annotate as multi-rib fracture. Scenario: S41.

Radiology / ECG / TEG Pulmonary contusion - bilateral / blast lung (CXR)

CURRENT

Extensive pulmonary contusion and deep sulcus sign.jpg

quality 4/5 · watermark: small

right contusion + basal lucency

Used in: S20 Ground Glass; S28 Downward Spiral

CANDIDATE

cxr-blast-lung-bilateral-contusion.jpg

Public domain — United States Army Medical Department (Public domain / US federal work)

Blast-injury soldier, bilateral pulmonary contusion infiltrates. Military-relevant, PD (no attribution required but credited). Scenarios: S20, S28.

Radiology / ECG / TEG Pulmonary contusion - focal/blunt (CXR)

CURRENT

Pulmonary contusion after gunshot wound.png

quality 3/5 · watermark: small

left mid-zone opacity; rotated film, marker artifacts

Used in: S20 Ground Glass

CANDIDATE

cxr-pulmonary-contusion-blunt.jpg

CC BY-SA 4.0 — Doc James (James Heilman, MD), Wikimedia Commons (CC BY-SA 4.0)

1095x840 focal pulmonary contusion after blunt chest trauma. Scenario: S20.

Radiology / ECG / TEG Inferior STEMI - 12-lead ECG

CURRENT

inferior_STEMI_ECG.jpg

quality 4/5 · watermark: small

textbook inferior STEMI (ST-elev II/III/aVF, reciprocal aVL); device header with ID/date, name blank (no PHI)

Used in: S11 Heart of the Matter

CANDIDATE

litfl-ecg-inferior-stemi.jpg

CC BY-NC-SA 4.0 — Life in the Fast Lane (LITFL) ECG Library (CC BY-NC-SA 4.0) - non-commercial use

1200x451 12-lead, ST elevation II/III/aVF with reciprocal changes. Scenario: S11 (Heart of the Matter). Commons PD alternate also exists (File:12 lead generated inferior MI.JPG).

Radiology / ECG / TEG Pelvic fracture (AP pelvis X-ray)

CURRENT

open pelvic fracture.png

quality 4/5 · watermark: small · label match: unsure

fracture not conspicuous; symphysis not obviously diastased

Used in: S6 Pelvis Down; S35 Triage Bypass

CANDIDATE

xray-pelvis-ap-fracture-ischium-acetabulum.jpg

CC BY-SA 4.0 — Cerevisae, Wikimedia Commons (CC BY-SA 4.0)

4608x3456 high-res AP pelvis with left inferior pubic ramus + acetabular wall fracture. NOTE: this is a stable ramus/acetabular fracture, NOT an open-book/unstable ring disruption - see gap note. Best openly-licensed AP pelvis radiograph found on Commons. Scenarios: S6, S35.

Radiology / ECG / TEG Urethral injury - retrograde urethrogram with contrast extravasation

CURRENT

pelvic trauma urethral injury.jpeg

quality 3/5 · watermark: small

RUG with contrast extravasation; low-res 40KB

Used in: S6 Pelvis Down; S22 Eyes and Below

CANDIDATE

urethrogram-retrograde-urethral-injury-extravasation.jpg

CC BY 4.0 — Alnadhari I, Abdelhaleem Abdeljaleel O, Sampige VRP, Abdulmuhsin A, Shamsodini A., Wikimedia Commons (CC BY 4.0)

584x499 retrograde urethrogram showing contrast extravasation from anterior urethra - the classic imaging sign of urethral injury. Scenarios: S6, S22.

➕ New additions (no current equivalent) (11)

Ultrasound Lung US M-mode - normal seashore sign NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

lung-mmode-seashore-normal.gif

CC BY-NC 4.0 — The POCUS Atlas (thepocusatlas.com), CC BY-NC 4.0

Normal comparison M-mode; 14MB GIF - consider converting to mp4 before deploy

Radiology / ECG / TEG Epidural hematoma (head CT) - NEW, no prior asset NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

ct-head-epidural-hematoma.jpg

CC BY-SA 4.0 — Hellerhoff, Wikimedia Commons (CC BY-SA 4.0)

1164x1037 non-contrast head CT, large biconvex/lentiform hyperdense epidural hematoma with mass effect. Fills a head-trauma imaging gap (S3 Lights Out, S16 ICP Climb have no CT asset).

Radiology / ECG / TEG TEG / thromboelastography normal trace - NEW, no prior asset NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

teg-normal-tracing-waveform.jpg

CC BY 2.0 — Luis Teodoro da Luz, Bartolomeu Nascimento, Sandro Rizoli, Wikimedia Commons (CC BY 2.0)

Labeled normal TEG signature waveform (R, K, alpha, MA). Reference figure for coagulopathy/DCR scenarios; no abnormal-trace equivalent found openly-licensed.

Radiology / ECG / TEG Hyperkalemia ECG - peaked T waves NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

ecg-hyperkalemia-peaked-t-waves.jpg

CC BY 4.0 — Dr. Michael-Joseph F. Agbayani and Dr. Eddieson Gonzales, Wikimedia Commons (CC BY 4.0)

1158x893 12-lead, K+ 8.2 mmol/L, tall peaked T waves. Replaces SVG placeholders in S34 (ekg_hyperK), S47 (ekg_peaked_s47). Real ECG paper look.

Radiology / ECG / TEG Hyperkalemia ECG - peaked T waves (LITFL, K 7.0) NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

litfl-ecg-hyperkalemia-peaked-t-serum-k-7.jpg

CC BY-NC-SA 4.0 — Life in the Fast Lane (LITFL) ECG Library (CC BY-NC-SA 4.0) - non-commercial use

1200x562 clean 12-lead, serum K 7.0, classic peaked/tented T waves. Alternate/higher-clarity option for S34/S47.

Radiology / ECG / TEG Hyperkalemia ECG - sine wave (peri-arrest, K 9.9) NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

litfl-ecg-hyperkalemia-sine-wave-serum-k-9.9.jpg

CC BY-NC-SA 4.0 — Life in the Fast Lane (LITFL) ECG Library (CC BY-NC-SA 4.0) - non-commercial use

Pre-terminal sine-wave hyperkalemia (K 9.9). Useful for the crush/reperfusion arrest scenarios (S21, S47) to show progression toward arrest.

Radiology / ECG / TEG Osborn (J) waves - hypothermia ECG NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

ecg-osborn-j-waves-hypothermia.gif

CC BY-SA 3.0 — Jer5150, Wikimedia Commons (CC BY-SA 3.0)

Static tracing (81yo, temp 31.9C) showing Osborn/J waves. Replaces SVG placeholders in S19, S30. Small (478x478) but clear.

Radiology / ECG / TEG Osborn (J) waves - hypothermia ECG (LITFL 12-lead) NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

litfl-ecg-hypothermia-osborn-j-waves.jpg

CC BY-NC-SA 4.0 — Life in the Fast Lane (LITFL) ECG Library (CC BY-NC-SA 4.0) - non-commercial use

1200x591 full 12-lead with prominent Osborn waves + bradycardia. Preferred high-res option for S19/S30 (Frozen Soldier, White Out).

Radiology / ECG / TEG Ventricular fibrillation - rhythm strip NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

ecg-ventricular-fibrillation.png

CC BY-SA 3.0 — Jer5150, Wikimedia Commons (CC BY-SA 3.0)

750x418 coarse VF tracing. Replaces SVG placeholder in S41 (ekg_vfib / Crack the Chest arrest).

Radiology / ECG / TEG Atrial fibrillation with rapid ventricular response - 12-lead ECG NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

litfl-ecg-atrial-fibrillation-rapid-vr.jpg

CC BY-NC-SA 4.0 — Life in the Fast Lane (LITFL) ECG Library (CC BY-NC-SA 4.0) - non-commercial use

1200x618 irregularly irregular AF at rapid rate, no P waves. Replaces SVG placeholder in S32 (Pump Failure / ekg_afib).

Radiology / ECG / TEG Pelvic fracture classification reference (Young-Burgess diagram) NEW — fills a gap, add via ➕ Add media

— no current file (new addition) —

CANDIDATE

not downloaded — see source page

⚠ Weak current files with NO candidate yet (3)

These graded ≤3/5 (or were flagged) and no open-license replacement was found automatically. Options: pull manually from ClinicalKey / AccessAnesthesiology (personal-use copy only — do not redistribute those), or shoot your own on the next POCUS session and use ➕ Add media.

Aortic Valve (Short) normal.gif — quality 3/5, dim 2013-dated frame, AV-level PSAX faintly visible; device UI header and menu bar; gif-first-frame-only
abdominal_GSW_wound.jpg — quality 4/5, thigh/flank GSW entry wound - no abdomen, no evisceration; ungloved examiner hand
⚠ LABEL MISMATCH: shows thigh/flank wound, scenario expects abdominal GSW (no candidate found — manual pick needed)
post bilateral chest tubes.jpeg — quality 3/5, soft 55KB image; tubes hard to trace but lungs expanded