(BQ) Part 1 book Pocket protocols for ultrasound presents the following contents: Evolution of point-of-care ultrasound, ultrasound physics, transducers, orientation, basic operation of an ultrasound machine, imaging artifacts, overview, lung and pleural ultrasound technique, lung ultrasound interpretation,...
Point-of-Care Ultrasound NILAM J SONI, MD Associate Professor of Medicine Division of Hospital Medicine University of Texas Health Science Center San Antonio San Antonio, Texas ROBERT ARNTFIELD, MD Assistant Professor Division of Emergency Medicine and Division of Critical Care Medicine Western University London Health Sciences Centre London, Ontario, Canada PIERRE KORY, MPA, MD Associate Professor of Medicine Fellowship Program Director Division of Pulmonary, Critical Care, and Sleep Medicine Mount Sinai Beth Israel Medical Center Icahn School of Medicine at Mount Sinai New York, New York 1600 John F Kennedy Blvd Ste 1800 Philadelphia, PA 19103-2899 POINT-OF-CARE ULTRASOUND ISBN: 978-1-4557-7569-9 Copyright © 2015 by Saunders, an imprint of Elsevier Inc No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein) Notices Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein ISBN: 978-1-4557-7569-9 Senior Content Strategist: Maureen Iannuzzi Content Development Specialist: Maria Holman Publishing Services Manager: Patricia Tannian Senior Project Manager: John Casey Designer: Steven Stave Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 CONTRIBUTORS Samuel Acquah, MD, FCCP Assistant Professor Director, Medical Intensive Care Unit Division of Pulmonary, Critical Care, and Sleep Medicine Mount Sinai Beth Israel Medical Center Icahn School of Medicine at Mount Sinai New York, New York Sara Ahmadi, MD Assistant Professor Division of Endocrinology University of Texas Health Science Center San Antonio San Antonio, Texas Phillip Andrus, MD, FACEP, RDMS Assistant Professor of Emergency Medicine Division of Emergency Ultrasound Icahn School of Medicine at Mount Sinai New York, New York Robert Arntfield, MD, FRCPC, FCCP, RDMS Assistant Professor Division of Emergency Medicine and Division of Critical Care Medicine Western University London Health Sciences Centre London, Ontario, Canada Anita Cave, MD, FRCPC Assistant Professor Department of Anesthesia and Perioperative Medicine London Health Sciences Centre London, Ontario, Canada Gregg L Chesney, MD Fellow, Critical Care Medicine Division of Pulmonary and Critical Care Medicine Stanford University School of Medicine Stanford Hospital and Clinics Stanford, California Alan T Chiem, MD, MPH Assistant Clinical Professor Director, Emergency Ultrasound Department of Emergency Medicine University of California, Los Angeles Olive View–UCLA Medical Center Los Angeles, California Christopher Dayton, MD Fellow, Critical Care Medicine Division of Critical Care Medicine Albert Einstein College of Medicine Montefiore Medical Center New York, New York Michel Boivin, MD Associate Professor Division of Pulmonary, Critical Care, and Sleep Medicine University of New Mexico Albuquerque, New Mexico Orlando Debesa, DO Assistant Clinical Professor of Medicine Division of Pulmonary and Critical Care Medicine Virginia Commonwealth University Richmond, Virginia Pedro Campos, MD Director, Emergency Ultrasound Sutter Medical Center of Santa Rosa Clinical Instructor University of California, San Francisco San Francisco, California Eitan Dickman, MD, FACEP Vice-Chair of Academics Director, Division of Emergency Ultrasound Department of Emergency Medicine Maimonides Medical Center New York, New York Carolina Candotti, MD Assistant Professor Division of Hospital Medicine Penn State Hershey Medical Center Hershey, Pennsylvania Peter Doelken, MD Associate Professor of Medicine Albany Medical College Albany, New York v vi CONTRIBUTORS Lewis A Eisen, MD Associate Professor of Clinical Medicine Assistant Professor of Clinical Neurology Division of Critical Care Medicine Albert Einstein College of Medicine Montefiore Medical Center New York, New York Patricia C Henwood, MD Instructor in Emergency Medicine Harvard Medical School Fellow in Emergency Ultrasound Department of Emergency Medicine Brigham and Women’s Hospital Boston, Massachusetts Daniel Fein, MD Division of Pulmonary, Critical Care, and Sleep Medicine Mount Sinai Beth Israel Medical Center Icahn School of Medicine at Mount Sinai New York, New York Patrick T Hook, MD, MS Fellow, Rheumatology Department of Rheumatology Boston University School of Medicine Boston, Massachusetts Stephanie Fish, MD Associate Professor Department of Medicine, Endocrine Division Memorial Sloan Kettering Cancer Center New York, New York Ricardo Franco, MD Associate Professor of Medicine Division of Hospital Medicine Rush University Medical College John H Stroger, Jr Hospital of Cook County Chicago, Illinois Colin Gebhardt, BScPT, MD Department of Adult Critical Care University of Saskatchewan Saskatchewan, Alberta, Canada Ben Goodgame, MD, RDMS Emergency Medicine Consultant Rotorua Hospital, Lakes District Rotorua, New Zealand Behzad Hassani, MD, CCFP (EM) Assistant Professor Division of Emergency Medicine London Health Sciences Centre London, Ontario, Canada Ahmed F Hegazy, MD, FRCPC Assistant Professor Division of Critical Care Medicine Department of Anesthesia and Perioperative Medicine Western University London Health Sciences Centre London, Ontario, Canada J Terrill Huggins, MD Associate Professor of Medicine Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine Medical University of South Carolina Charleston, South Carolina Adolfo Kaplan, MD, FCCP Pulmonologist McAllen Health Sciences Center McAllen, Texas Chan Kim, MD Clinical Instructor Department of Rheumatology Boston University School of Medicine Boston, Massachusetts Eugene Kissin, MD Associate Professor of Medicine Department of Rheumatology Boston University School of Medicine Boston, Massachusetts Pierre Kory, MPA, MD, MHS Associate Professor of Medicine Fellowship Program Director Division of Pulmonary, Critical Care, and Sleep Medicine Mount Sinai Beth Israel Medical Center Icahn School of Medicine at Mount Sinai New York, New York Daniel Lakoff, MD Associate Director, Emergency Ultrasound Department of Emergency Medicine Icahn School of Medicine at Mount Sinai New York, New York vii CONTRIBUTORS Viera Lakticova, MD Assistant Professor of Medicine Director, Interventional Pulmonology North Shore–Long Island Jewish Medical Center New Hyde Park, New York Scott Millington, MD, FRCPC Assistant Professor of Medicine Department of Critical Care Medicine University of Ottawa and The Ottawa Hospital Ottawa, Ontario, Canada Catherine Y Lau, MD Assistant Clinical Professor of Medicine Director, Neurological Surgery Patient Safety and Quality Department of Medicine University of California, San Francisco San Francisco, California Paul K Mohabir, MD Clinical Associate Professor Director, Adult Cystic Fibrosis Program Division of Pulmonary and Critical Care Medicine Stanford University School of Medicine Stanford, California Alycia Lee, BS, RDCS, RVT School of Medicine and Health Sciences The George Washington University Washington, DC Arun Nagdev, MD Director, Emergency Ultrasound Alameda Health System Highland General Hospital Oakland, California Peter M.J Lee, MD, MHS Division of Pulmonary, Critical Care, and Sleep Medicine Mount Sinai Beth Israel Medical Center Icahn School of Medicine at Mount Sinai New York, New York W Robert Leeper, MD, FRCSC Trauma and Acute Care Surgery Fellow Department of Surgery, Division of Acute Care Surgery Johns Hopkins University School of Medicine Baltimore, Maryland Shankar LeVine, MD Alameda Health System Highland General Hospital Oakland, California Ken Lyn-Kew, MD Assistant Professor of Medicine Division of Pulmonary Science and Critical Care Medicine University of Colorado National Jewish Health Denver, Colorado Daniel Mantuani, MD, MPH Department of Emergency Medicine Alameda Health System Highland General Hospital Oakland, California Michael Mayette, MD, FRCPC Assistant Professor Critical Care Medicine Université de Sherbrooke Sherbrooke, Québec, Canada Mangala Narasimhan, DO, FCCP Section Head, Critical Care Medicine Associate Professor of Medicine North Shore–Long Island Jewish Medical Center New Hyde Park, New York Paru Patrawalla, MD Assistant Professor of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine New York University School of Medicine New York, New York Daniel R Peterson, MD, PhD, FRCPC, RDMS Clinical Assistant Professor Academic Department of Emergency Medicine University of Calgary Foothills Medical Centre Calgary, Alberta, Canada Nitin Puri, MD, FCCP Assistant Professor of Medicine Medical Director, Cardiac Surgery Intensive Care Unit Virginia Commonwealth University Inova Fairfax Hospital Falls Church, Virginia Shideh Shafie, MD Department of Emergency Medicine Maimonides Medical Center Brooklyn, New York viii Ariel L Shiloh, MD Director, Critical Care Consult Service Assistant Professor of Clinical Medicine and Neurology Division of Critical Care Medicine, Department of Medicine Albert Einstein College of Medicine Jay B Langner Critical Care Service Montefiore Medical Center Bronx, New York Michael Silverberg, MD Division of Pulmonary, Critical Care, and Sleep Medicine Department of Emergency Medicine Mount Sinai Beth Israel Medical Center Icahn School of Medicine at Mount Sinai New York, New York CONTRIBUTORS Michael Stone, MD Chief, Division of Emergency Ultrasound Department of Emergency Medicine Brigham and Women’s Hospital Boston, Massachusetts Christopher R Tainter, MD, RDMS Fellow, Critical Care Medicine Massachusetts General Hospital Harvard Medical School Boston, Massachusetts Stefan Tchernodrinski, MD, MS Division of Hospital Medicine John H Stroger, Jr Hospital of Cook County Assistant Professor of Medicine Rush University Medical College Chicago, Illinois Craig Sisson, MD, RDMS Clinical Associate Professor Department of Emergency Medicine University of Texas Health Science Center San Antonio San Antonio, Texas Ryu P.H Tofts, MbCHb Division of Pulmonary, Critical Care, and Sleep Medicine Mount Sinai Beth Israel Medical Center Icahn School of Medicine at Mount Sinai New York, New York Diane Sliwka, MD Associate Clinical Professor of Medicine Director, Mt Zion Medical Service Division of Hospital Medicine Department of Medicine University of California, San Francisco San Francisco, California Christopher Walker, MD Fellow, Critical Care Medicine Division of Pulmonary and Critical Care Medicine Stanford University School of Medicine Stanford, California Nilam J Soni, MD, FHM, FACP Associate Professor of Medicine Division of Hospital Medicine University of Texas Health Science Center San Antonio San Antonio, Texas Kirk T Spencer, MD, FASE Professor of Medicine Section of Cardiology Department of Medicine University of Chicago Chicago, Illinois Ralph C Wang, MD Associate Professor of Emergency Medicine Department of Emergency Medicine University of California, San Francisco San Francisco, California Michael Y Woo, MD, CCFP(EM), RDMS Associate Professor Director, Emergency Medicine Ultrasound Program Director, Emergency Medicine Ultrasound Fellowship Department of Emergency Medicine University of Ottawa and The Ottawa Hospital Ottawa, Ontario, Canada This book is dedicated to all the compassionate and dedicated clinicians who strive to provide the best bedside care to their patients To those who inspire me — my parents, Jay and Niru, and my children, Riya and Devak — and to the one whose sacrificial support makes it all possible, Perla NS To my parents, Peg and David, for their lifelong support, my children, Amelia and John, for reminding me what is most important, and my wife, Shannon, for her boundless love and encouragement RA To my angels, Amy, Ella, Eve, and Violet, along with my dear parents, Leslie and Odile, for their unwavering patience, support, and love PK PREFACE Point-of-care ultrasound has been rapidly integrated into clinical practice in recent years, and its role in medicine will continue to expand in coming decades Point-of-care ultrasound has been shown to make procedures safer, expedite diagnoses, and raise confidence in clinical decision making In addition to these clinical benefits, point-of-care ultrasound is one of few technologies that brings providers closer to patients, putting them right at the bedside, raising the satisfaction of providers and patients alike This book is intended for providers of any healthcare discipline interested in learning about the principles and diverse applications of point-of-care ultrasound Covered in detail are specific point-of-care ultrasound applications that are most generalizable to healthcare providers from a broad spectrum of specialties and practice settings All chapters are based on the best available evidence supplemented by expert opinion Nilam J Soni Robert Arntfield Pierre Kory xi ACKNOWLEDGMENTS For contributing ultrasound images: Danny Duque, MD, RDMS, FACEP Assistant Professor Department of Emergency Medicine Elmhurst Hospital Center New York, New York Laleh Gharahbaghian, MD Clinical Assistant Professor Department of Emergency Medicine Stanford University Medical Center Alycia Paige Lee, BS, RDCS, RVT School of Medicine and Health Sciences The George Washington University Washington, DC Jennifer Huang, DO, FACEP Assistant Professor Department of Emergency Medicine Mt Sinai Hospital New York, New York Bret P Nelson, MD, RDMS, FACEP Associate Professor Department of Emergency Medicine Mt Sinai Hospital New York, New York Roya Etemad Rezai, MD, FRCPC Associate Professor Department of Diagnostic Radiology and Nuclear Medicine Western University London Health Science Centre London, Ontario, Canada Ee Tay, MD, FAAP Assistant Professor Department of Emergency Medicine (Pediatrics) Mt Sinai Hospital New York, New York Nate Teismann, MD Assistant Clinical Professor Department of Emergency Medicine University of California San Francisco San Francisco, California Drew Thompson, MD, FRCPC Associate Professor Department of Emergency Medicine Western University London Health Sciences Centre London, Ontario, Canada xii Brita E Zaia, MD, FACEP Director, Emergency Department Ultrasound Department of Emergency Medicine Kaiser Permanente San Francisco Medical Center San Francisco, California For developing original illustrations and photography: Victoria Heim, CMI Medical Illustrator Loganville, Georgia Jade Myers Graphic Designer Matrix Art Services York, Pennsylvania Lester Rosebrock Photographer University of Health Science Center San Antonio San Antonio, Texas Sam Newman Medical Animator University of Texas Health Science Center San Antonio San Antonio, Texas Jordan Hill, BA Health & Fitness Consultant San Antonio, Texas For serving as a mentor and educator in the field: Paul Mayo, MD Professor of Clinical Medicine Hofstra North Shore–LIJ School of Medicine Long Island Jewish Medical Center New Hyde Park, New York Gary White, PhD Editor, The Physics Teacher American Association of Physics Teachers Adjunct Professor of Physics George Washington University Washington, DC ... York 16 00 John F Kennedy Blvd Ste 18 00 Philadelphia, PA 19 10 3-2 899 POINT- OF- CARE ULTRASOUND ISBN: 97 8 -1 -4 55 7-7 56 9-9 Copyright © 2 015 by Saunders, an imprint of Elsevier Inc No part of this... development of point- of- care ultrasound applications and incorporation of these applications into routine clinical practice Since the 19 90s, point- of- care ultrasound has become a part of nearly... specialty’s practice In addition to development of specific point- of- care ultrasound applications in the 1 EVOLUTION OF POINT- OF- CARE ULTRASOUND 19 90s, such as the FAST exam, general medical ultrasound