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Ultrasound in Anesthetic Practice

Graham Arthurs and Barry Nicholls

CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo, Delhi

Cambridge University Press
The Edinburgh Building, Cambridge CB2 8RU, UK

Published in the United States of America by Cambridge University Press, New York

www.cambridge.org
Information on this title: www.cambridge.org/9780521716239

© Cambridge University Press 2009

This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press.

First published 2009

Printed in the United Kingdom at the University Press, Cambridge

A catalogue record for this publication is available from the British Library

Library of Congress Cataloguing in Publication data

Ultrasound in anaesthetic practice / edited by Graham Arthurs and Barry Nicholls.
  p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-521-71623-9 (pbk)
1. Diagnostic ultrasonic imaging. 2. Anesthesiology. I. Arthurs, G. II. Nicholls, Barry.
[DNLM: 1. Ultrasonography. 2. Anesthesia – methods. 3. Anesthesiology.
4. Clinical Medicine – methods. WN 208 U4746 2009]
RC78.7.U4U4465 2009
616.07∲543 – dc22 2008037145

ISBN 978-0-521-71623-9 paperback

Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Every effort has been made in preparing this publication to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

All material contained within the DVD is protected by copyright and other intellectual property laws. The customer acquires only the right to use the DVD and does not acquire any other rights, express or implied, unless these are stated explicitly in a separate licence.

To the extent permitted by applicable law, Cambridge University Press is not liable for direct damages or loss of any kind resulting from the use of this product or from errors or faults contained in it, and in every case Cambridge University Press’s liability shall be limited to the amount actually paid by the customer for the product.

Contents

Contributors

Vishwanath Acharya mrcp frcr

Graham Arthurs obe mb chb frca ffpmfra med

Owen Arthurs ma mb bchir phd mrcpch

Andy Bodenham frca

Dennis LI. Cochlin mb bch frcr

Trevor Frankel bsc avs

Philip Haslam, mb bs mrcp frcr

Geoff Hide mb bs mrcp frcr pgdip clin ed

Patrick Hill ma csci mipem

Tom Ingram mb chb mrcp

Stephan Kapral md

Robert Kong mbbs frca

Chandra M. Kumar mbbs darcs ffarcsi msc frca

Peter Marhofer md

Barry Nicholls frca

John Oram frca dicm

David Parker fhfa frcp frcr

Sapna Puppala mrcs frcsed, frcr

Alice Roberts mb bch bsc

Steve Roberts frca

Henry Skinner frca

Julian Skoyles frca

William Taylor m.obst, frcog

Amy Walker mb, chb, frca

Preface

The aim of this book is to provide a practical introduction to medical ultrasound. A few years ago we searched in vain for a book that would give the clinician an introduction to the use of ultrasound in clinical practice. There were many specialist books but no easy to read book that told a trainee or clinician about all the possible uses of ultrasound, what they could learn to do for themselves, and when they should ask others to help. As we explored the subject, we realized that ultrasound is both complicated to understand properly and yet simple to use in practice. In all, we have identified 12 aspects of medical practice in which ultrasound has a part to play. We approached clinicians who are experts in their fields to write a well-illustrated guide to the use of ultrasound.

Clinical ultrasound involves identifying normal and abnormal patterns. We felt that the best way of helping the reader to identify these patterns was to present as many ultrasound scans as possible. This has been made possible by the use of a series of PowerPoint presentations on the accompanying DVD.

The combination of a text book with a DVD combines the best of both educational tools. We hope that the reader will study the text but at the same time view the illustrations on their laptop. In this way the images are reproduced nearer to their original quality. The images will also be larger than possible in any printed text. The video clips show movement, such as the action of the heart, in a way that cannot be achieved in an ordinary text book.

While the first ultrasound was used clinically about 50 years ago, it is the rapid development of micro-computer technology in the past 10 years that has brought ultrasound into everyday clinical practice. It is likely that within the next 10 years, portable ultrasound devices will be carried by all clinicians as they carry a stethoscope or laptop today. We hope that this book will be of help to many students, trainees and practitioners who need to know what this technology can and cannot do. There are also mature clinicians, like ourselves, who have not been brought up with ultrasound, and we hope they will find this a useful way to update their knowledge.

The objective that was set each author was to produce an introduction to their specialist area; to explain what ultrasound can and cannot do; to give practical guidance on how to obtain the best results; to encourage the greater but safer use of ultrasound; and to indicate when to seek further help.

In any multi-authored book, it is inevitable that there will be some overlap between the presentations. These have not been edited out, as each author wrote their chapter as a stand-alone text. Reading more than one explanation of the same subject can also aid understanding.

We are very grateful to all the authors for their efforts, to Tony Bailey and Dr. Alice Roberts for drawing the illustrations, and to the staff at Cambridge University Press for bringing the whole to a successful conclusion.

Graham Arthurs
Barry Nicholls