Especielly when qSOFA was never made as a sepsis diagnosis criteria, but a mortality risk assessment. That's widely different applications and people still use it as a "sepsis or not" tool.

Also, they do mention investigating lung-sliding, and if not, M-mode for barcode and stratosphere sign were used. Why not assessment for B-lines and lung pulse? Long point is not mentioned?
I don't have access to their previous publication on their protocols, sadly.

Intersting findings. I agree, PTX diagnosis by LUS/FLUS can be difficult and easily missed it if not careful.

In our setting, using sonographers are not usual for these kind of investigations. Especielly LUS/FLUS is primarily done by EM, IM (Pulm) and ICU staff, not radiology.