Practical Ultrasound in Anesthesia for Critical Care and Pain Management

242 Pages·2008·5.74 MB·English

by  M. Hopkins Philip

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Anesthesiology
about the book… P
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Practical Ultrasound in Anesthesia for Critical Care and Pain Management is a stand-alone c
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comprehensive reference that covers important aspects of ultrasound for the practicing ic Practical Ultrasound in
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anesthesiologist. Beginning with a background on the physics of equipment and practical l

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applications, this text takes the specialist through subjects like needle visualization, teaching, l
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training, accreditation, and getting the best out of your ultrasound equipment. r
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s Anesthesia for Critical Care
With high-resolution ultrasound photographs Practical Ultrasound in Anesthesia for Critical o
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Care and Pain Management covers topics that explore: n
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• vascular access • basic echo Doppler
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• nerve blockade • transesophageal Doppler A and Pain Management
• echocardiography • transcranial Doppler n
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• transesophageal echocardiography - • the respiratory system s
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evaluation of the valves h
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Also included is a fully developed CD, that includes high-resolution video clips of actual s
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ultrasound examples, organized in an easy cross-referenced fashion for the busy clinician.
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about the editors... r
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PHILIP M. HOPKINS is Professor of Anesthesia, University of Leeds, Director, UK National i
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Malignant Hyperthermia Investigation Unit, and Honorary Consultant Anesthetist, Leeds c
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Teaching Hospitals Trust, Leeds, UK. Dr. Hopkins received his M.D. from the University of Leeds, l

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Leeds, UK. Dr. Hopkins currently serves as an Editorial Board member of the British Journal of a
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Anaesthesia and is a member of the ESA Research Committee. Dr. Hopkins’s research consists e

primarily of anesthesia and intensive care medicine in relation to malignant hyperthermia, a
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exertional heat illness and stroke, as well as drug reactions and allergies, and the use of d

ultrasound-guided techniques in regional anesthesia. P
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A. R. BODENHAM is Director of Intensive Care and Consultant in Anesthesia, Leeds General n

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Infirmary, Leeds, UK. Dr. Bodenham obtained his M.D. from St. Bartholomew’s Hospital in
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London, UK. Dr. Bodenham specializes in anesthesia and intensive care, with an interest in n
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interventional procedures, as well as vascular surgery and access procedures. Dr. Bodenham g
continues to perform studies on the airway, as well as central venous access, ultrasound guided e
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procedures, and sepsis management. e
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SCOTT T. REEVES is the John E. Mahaffey, MD Endowed Professor and Chair of the Department
of Anesthesia and Perioperative Medicine at the Medical University of South Carolina, Charleston,
South Carolina, USA. Dr. Reeves received his M.D. from the Medical University of South Carolina,
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Charleston, South Carolina, USA. He did his residencies in Internal Medicine and Anesthesiology o
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at Baylor College of Medicine and advance training in pediatric cardiothoracic anesthesiology kin
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at the Texas Heart Institute, in Houston, Texas, USA. Dr. Reeves is a fellow of the American •
Society of Echocardiography and the American College of Cardiology and is very active as Bo
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program chair for the Society of Cardiovascular Anesthesiology. Dr. Reeves’s research concentrates en
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on scardiac anesthesiology, perioperative transesophageal echocardiography and pain a
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perception in surgery patients. •
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Printed in the United States of America ev
DK3560 e
s Edited by
Philip M. Hopkins A. R. Bodenham Scott T. Reeves
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Practical Ultrasound in
Anesthesia for Critical Care
and Pain Management
Hopkins_978-0824728861_TP.indd 1 8/13/08 4:32:35 PM

Practical Ultrasound in
Anesthesia for Critical Care
and Pain Management
Edited by
Philip M. Hopkins
University of Leeds
Leeds, UK
A. R. Bodenham
Leeds General Infirmary
Leeds, UK
Scott T. Reeves
Medical University of South Carolina
Charleston, South Carolina, USA
Hopkins_978-0824728861_TP.indd 2 8/13/08 4:32:35 PM
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LibraryofCongressCataloging-in-PublicationData
Practicalultrasoundinanesthesiaforcriticalcareandpain
management/editedbyPhilipM.Hopkins,AndrewR.Bodenham,
ScottT.Reeves.
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN978-0-8247-2886-1(hb:alk.paper) 1. Ultrasonicimaging.
2. Anesthesia.3. Criticalcaremedicine.4. Analgesia. I.Hopkins,
PhilipM.II.Bodenham,Andrew.III.Reeves,ScottT.
[DNLM:1. Anesthesia—methods.2. CriticalCare—methods.3. Pain—therapy.
4. Ultrasonography,Interventional—instrumentation. 5. Ultrasonography,
Interventional—methods. WO200P89552008]
RC78.7.U4P7332008
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To
My Savior, Jesus Christ, who gives me strength…
My wife, Cathy, who loves and puts up with me…
My children, Catherine, Carolyn, Townsend, who give me great joy…
My patients, who inspire me to do my best daily!
Scott T. Reeves, MD
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Preface
The uses and applications of medical ultrasound are increasing, particularly outside
traditionalareasofradiologypractice.Anesthesiologycriticalcareandpainmanagement
are no exception. Just about every invasive procedure in the body can potentially be
enhanced by the use of ultrasound. The introduction of small, portable, easy-to-use, and
relativelyinexpensiveultrasoundmachineshasacceleratedtheuseofsuchdevicesatthe
bedside by specialists in anesthesiology and related disciplines. Similar changes are
occurring in other specialties such as surgery, accident and emergency medicine, and
gastroenterology.Nevertheless,theuseofsuchdevicesoutsideradiologyhasnotmetwith
universalapproval.Issuesofcompetency,training,andaccreditationhaveallbeenraised
and are clearly important as these techniques enter mainstream practice.
In this book, we provide core knowledge of how to use ultrasound devices safely.
We then explain practical applications of these devices. The main areas where such
techniques are to be used include the vascular system, the nervous system, the heart, the
respiratory system, and miscellaneous other areas of the body. This will be of value to
anesthesiologists and critical care physicians. Pain specialists will be interested in
applications for nerve blocks. The book is not meant to be the definitive reference for
ultrasoundintheseareas;ratheritisaimedtoprovideausefulintroductioncombinedwith
detailedpracticalinformationonthemorecommonlyusedapplications.Whilecateringto
the needs of trainees inanesthesiology, criticalcare, and pain medicine who would want
to apply the latest techniques from the outset, we also hope to assist accredited and
certified specialists in these areas to introduce ultrasound techniques safely into their
routine practice.
Philip M. Hopkins
A. R. Bodenham
Scott T. Reeves
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Contents
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ix
1. Applied Physics of Medical Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . 1
J. A. Evans
2. Practical Applications—Getting the Best Out of Your Ultrasound
Machine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Heather Venables
3. Assessment of Needle, Catheter, and Guidewire Position Using
Ultrasonography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
G. A. Chapman and A. R. Bodenham
4. Teaching, Training, and Accreditation . . . . . . . . . . . . . . . . . . . . . . . . 47
Heather Venables
5. Ultrasound-Guided Vascular Access . . . . . . . . . . . . . . . . . . . . . . . . . . 57
A. R. Bodenham
6. Ultrasound-Guided Peripheral and Regional Nerve Block . . . . . . . . . . 71
Pawan K. Gupta and Philip M. Hopkins
7. Transesophageal and Transthoracic Echocardiography:
Examination Techniques and Views . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Bryan May, Kim Payne, and Scott T. Reeves
8. Perioperative Transesophageal Echocardiography of the Heart Valves . . 111
David A. Zvara, Daniel D. Amitie, Jason J. Baggett, and Christopher E. Beck
9. Basic Echo Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Mary Beth Brady
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