Ultrasound in Anesthesia, Critical Care, and Pain Management, 2nd ed

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Excerpt

Editors Graham Arthurs and Barry Nicholls went beyond the call of duty when gathering expert authors to write this updated comprehensive guide to medical ultrasound. They set out to create a reference that would improve the understanding and practice of ultrasound by clinicians and trainees, and they have succeeded. The authors of the text describe the application of ultrasound in anesthesiology, critical care, and pain management; however, this book is likely to appeal to a broader audience. The digital supplement to the book includes video clips, which increase the readers’ exposure to relevant images by allowing them to view ultrasound sequences while simultaneously reading the accompanying chapter.
Ultrasound physics is rarely an “electrifying” topic, but understanding physics is crucial in order to appropriately use ultrasound technology. The first chapter provides a concise overview of the key concepts of this subject without overwhelming the reader. The remainder of the book discusses the benefits of ultrasound for essential practices, including vascular access, basic echocardiography, airway management, trauma, critical care, and regional anesthesia.
While the multitude of authors makes for a notable difference in writing styles and, at times, an inconsistent feel to the text as a whole, it also creates a more engaging and personal experience for the reader. For example, chapter 2 was written by an interventional radiologist, and his chapter includes a significant amount of personal experience (“I learned” or “I have used”), as well as a heavy focus on specific brands of equipment. While this seemed out of place and did little to improve the readers’ understanding of ultrasound, the content is clinically relevant and complete. For anesthesiologists, it would have been advantageous to have a more detailed account of ultrasound-guided subclavian vein access and wire confirmation, as well as avoidance of the median nerve when performing a brachial arterial line with ultrasound. These are just a few examples of how the chosen author, though an expert in his/her field, may not be able to fully reach the intended audience due to differing scopes of practice. As a result of the many different chapter authors, there is an abundance of repeated information, which the editors warn of in the preface. This, however, could be viewed as a mechanism for reemphasizing important content rather than redundancy.
Given the nature of the book, it is important to critique the image quality provided. With a background in perioperative echocardiography, we were excited to read chapter 3. The schematics of this chapter are clear and well organized; however, 1 important limitation of this chapter is that the ultrasound images are relatively low quality. They are unmarked and in black and white, meaning that color flow Doppler images do not add additional value. Recognizing this limitation, the authors opted to include additional online images to bridge the gap. The online content, which includes crisper echo images, short video clips, and colored diagrams that are both aesthetically pleasing and essential when discussing color flow findings, more than adequately compensates for the limitations of the still images.
In terms of content omitted from the text, there is little to none. As mentioned in the above paragraph, ultrasound-guided vascular access has become standard practice in the field of anesthesia. What used to be an interventional radiology procedure has become routine for the general anesthesiologist. That having been said, this book aims to identify areas in which ultrasound can be used safely and in which the provider should ask for help.

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