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Leanne Hartnett is a massive fan of bedside ultrasound. Here, she tells a story of using ultrasound for the diagnosis of acute pulmonary embolus and the decision-making process for management. This is the story of a 65-year-old man who was brought into the Emergency Department with acute shortness of breath and chest tightness. This was on a background of motor neuron disease, due to which he was confined to a wheelchair. Despite this he reported a good quality of life. He enjoyed getting out and about with his wife, spending time with his family and reading the newspaper. In saying this, he was aware of the seriousness of his disease, and did not want any invasive treatments or CPR. The history and examination were unremarkable, although Leanne’s clinical suspicion of a pulmonary embolism was still high. She wanted to order a CT pulmonary angiogram. However her patient was sure he would not tolerate laying flat for that length of time. So, Leanne wheeled over the ultrasound machine. Despite the technical dif