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 Do not mistake chest wall for pleural line.

 While absence of lung sliding suggests pneumothorax, it can occur in a variety of other situations such as pulmonary fibrosis and contusions, bullous emphysema, mainstem intubation, and pleurodesis.

 Routinely check for lung sliding before and after any transthoracic procedure to evaluate for iatrogenic pneumothorax, e.g. central venous access.

 Examining for pleural effusion with head of bed elevated may improve sensitivity as fluid will accumulate above diaphragms.