Emergency Ultrasound, Second Edition

Nothing induces palpitations, nausea, and lightheadedness quite like receiving your first ultrasound request as a radiology resident on the first night of call. Maybe, prior to this, you have done plenty of exams on your own with image quality equal or superior to the most experienced ultrasound techs in your department. Maybe your attending radiologists have already sung your praises for your outstanding knowledge of sonographic anatomy, physics, and artifacts. If this is the case, Emergency Ultrasound is not for you. However, if you need a basic guide for learning what you need to know to be helpful in the emergency department, this book is excellent.

As expected, given its title, the bulk of book’s contents concentrates on the main indications for ultrasound coming out of the emergency department: trauma, hepatobiliary pathology, obstetric and gynecologic complaints, testicular pain, and deep vein thrombosis. The breadth and depth of information is more than sufficient for precall preparation, initial reading on a regular ultrasound rotation, or as a refresher.

Each of the major chapters begins with a brief review of the emergency medicine literature outlining how sonography fits in with the current emergency department approach to diagnosis and treatment of the particular disease processes. Next the authors use diagrammatic illustrations with corresponding sonographic images and photographs of a live model being imaged to show normal anatomy, optimal patient positioning, and probe settings. Each chapter delineates a specific sequence of images to acquire and what structures must be identified and evaluated. Next, images are shown of common positive findings as well as some normal variants. Finally, each chapter concludes with a number of case studies underscoring key points. The chapters are well organized, and it is easy to flip through for a quick review or as a preparatory exercise. The images are of good quality and quite effective.

An additional major benefit is the DVD with a real-time video version of instructions on performing ultrasound on a subset of the major indications, including first-trimester pelvic ultrasound, deep venous thrombosis, hepatobiliary, abdominal aortic aneurysm, trauma, cardiac, and vascular access. The viewer can see sonographic images change as the transducer is moved on a patient model, and as the narrator-sonographer describes the techniques.

The third major positive component of the text lies in its coverage of ultrasound-guided procedures such as vascular access, joint aspiration, lumbar puncture, and even nerve blocks. As with the other chapters, there are good sonographic images and model photographs. These chapters would make a useful introductory or refresher reference to consult prior to performing many ultrasound-guided procedures.

Rounding out the training for a budding sonographic imager, there is a chapter outlining the basic physics underlying sonography as well as showing several pictorial examples of typical imaging artifacts encountered, from dirty shadowing to mirror image artifacts to incorrect gain settings. This offers a great start to minimizing one of the more challenging aspects to performing ultrasound.

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Emergency Ultrasound, Second Edition

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