Ultrasound in Anesthetic Practice
Ultrasound in Anesthetic Practice
Graham Arthurs and Barry Nicholls
CAMBRIDGE UNIVERSITY PRESS
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Cambridge University Press
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Published in the United States of America by Cambridge University Press, New York
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
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List of contributors
1 Principles of medical ultrasound
Graham Arthurs, Patrick Hill and Trevor Frankel
2 Ultrasound to aid vascular access
3 Diagnostic echocardiography
4 The role of echocardiography in the hemodynamically unstable patient in critical care and the operating theater
Julian Skoyles and Henry Skinner
5 Transesophageal diagnostic Doppler monitoring
6 Use of ultrasound in the intensive care unit
John Oram and Andrew Bodenham
7 Use of ultrasound in the traumatized patient and the acute abdomen
Sapna Puppala, Vishwanath Acharya, David A. Parker and Dennis LI. Cochlin
8 Use of ultrasound to aid local anesthetic nerve blocks in adults
Barry Nicholls, Stephan Kapral, Peter Marhofer and Alice Roberts
9 Use of ultrasound to aid local anesthetic nerve blocks in children
Amy Walker and Steve Roberts
10 Cranial ultrasound in the newborn
11 The use of ultrasound in acute gynecology and pregnancy assessment
12 Ultrasound in ophthalmic anesthesia
Chandra M. Kumar
13 Use of ultrasound in assessing soft tissue injury
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
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.
© Cambridge University Press