If you have an echo machine, it is important to use it! An echo machine, rather than a general purpose ultrasound machine, should have sector transducers. It will almost certainly have cardiac software on it as well – for 2D and M-mode measurements and calculations. You might even have colour flow and spectral Doppler software. So, the machine has all the capabilities you need – what about you? Even if you are not confident or trained, as a first step, just with transducer on chest, you can do the following to triage patients: is there a pleural or pericardial effusion? Are there B-lines? These are radial, hyperechoic lines showing the lung parenchyma has a mixture of air and fluid – so pulmonary oedema (or other pulmonary infiltrate) is detected. Can you identify if the left atrium is dilated? (if not, respiratory signs are not likely to be associated with left sided congestive heart failure). To increase confidence, do attend a practical echo course. It is always difficult using a different type of echo machine to the one we know – so consider working with someone (or attending a course) with a similar machine, to learn how to use it well.