Ultrasound: Part 2

Contents

Diagnostic Ultrasonography for Peripheral Vascular Emergencies 185

Thomas Cook, Laura Nolting, Caleb Barr, and Patrick Hunt

Over the past decade, emergency and critical care physicians have beenempowered with the ability to use bedside ultrasonography to assist inthe evaluation andmanagement of a variety of emergent conditions. Todaya single health care provider at the bedside with Duplex ultrasound tech-nology can evaluate peripheral vascular calamities that once requiredsignificant time and a variety of health care personnel for the diagnosis.This article highlights peripheral thromboembolic disease, aneurysm,pseudoaneurysm, and arterial occlusion in the acute care setting.

Bedside Ultrasonography for Obstetric and Gynecologic Emergencies 207

Aparajita Sohoni, Justin Bosley, and Jacob C. Miss

There has been an increase in the availability and use of bedside ultraso-nography in the acute care setting. The approach to the female patient witha pelvic complaint (including pelvic pain, vaginal bleeding, vaginal bleedingin pregnancy, or vaginal discharge) has been transformed by the useof bedside ultrasonography. Providers familiar with the transabdominaland transvaginal (endocavitary) ultrasonographic examination can obtainmore accurate information faster, thereby improving time to consultationor discharge and achieving an increase in patient satisfaction. This articlereviews the use of ultrasonography for evaluation of obstetric and gyneco-logic complaints in the acute care setting.

Bedside Ocular Ultrasound 227

Pedro J. Roque, Nicholas Hatch, Laurel Barr, and Teresa S. Wu

Many ocular emergencies are difficult to diagnose in the emergency set-ting with conventional physical examination tools. Additionally, persistentefforts to re-examine the eye may be deleterious to a patient’s overall con-dition. Ultrasound is an important tool because it affords physiciansa rapid, portable, accurate, and dynamic tool for evaluation of a varietyof ocular and orbital diseases. The importance of understanding orbitalanatomy, with attention to the firm attachment points of the various layersof the eye, cannot be understated. This article describes the relevant eyeanatomy, delves into the ultrasound technique, and illustrates a variety oforbital pathologies detectable by bedside ultrasound.

Bedside Musculoskeletal Ultrasonography 243

Mary J. Connell and Teresa S. Wu

Bedside sonography for the evaluation of soft tissue and musculoskeletalconditions has become indispensible for physicians caring for patients incritical, emergency, and urgent care settings. This article reviews indica-tions, techniques, and imaging appearances of common conditions en-countered in clinical practice.

Contentsvi

Basic Ultrasound-guided Procedures 275

Laurel Barr, Nicholas Hatch, Pedro J. Roque, and Teresa S. Wu

Use of bedside ultrasound to guide simple procedures increases safety byallowing real-time visualization of patient anatomy. This article discussesultrasound guidance for basic procedures including peripheral and centralintravenous access, arterial access, suprapubic aspiration, abscess inci-sion and drainage, foreign body identification, and joint arthrocentesis. Itreviews the indications and complications of the procedure, advantagesof ultrasound guidance, anatomy, and procedural technique.

Advanced Ultrasound Procedures 305

Nicholas Hatch and Teresa S. Wu

Ultrasound guidance has become the standard of care for many bedsideprocedures, owing to its portability, ease of use, and significant reductionin complications. This article serves as an introduction to the use of ultra-sonography in several advanced procedures, including pericardiocente-sis, thoracentesis, paracentesis, lumbar puncture, regional anesthesia,and peritonsillar abscess drainage.

Index 331