Focused questions for soft tissue and musculoskeletal

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Focused questions for soft tissue and musculoskeletal ultrasound 214 Anatomy 214 Technique 215 Scanning tips 219 Normal images 219 Abnormal images 221 Literature review 224 New directions 224 References 225 12. Gastrointestinal ultrasound 227 Introduction 227 Focused questions for gastrointestinal ultrasound 232 Anatomy 232 Technique 233 Scanning tips 235 Normal images 236 viii Contents Contents
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Abnormal images 236 Literature review 238 New directions 239 References 239 13. Pediatric ultrasound 241 Introduction 241 Focused questions for pediatric ultrasound 246 Anatomy 247 Technique 248 Scanning tips 249 Normal images 249 Abnormal images 251 Literature review 253 New directions 253 References 253 14. Ultrasound in shock 255 Introduction 255 General approach to the patient in shock 255 Cardiac ultrasound 255 Inferior vena cava 258 The FAST exam 261 Aorta 261 Pleura and lung 262 Sample clinical protocol 263 Literature review 265 References 266 SECTION 2: PROCEDURAL ULTRASOUND 269 15. Vascular access 273 Introduction 273 Focused questions for vascular access 273 Anatomy 273 Technique 277 Scanning tips 288 Pitfalls 288 Cannulation of the subclavian vein 289 Cannulation of the external jugular vein 289 Contents ix Contents
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Peripheral venous cannulation 289 Literature review 294 References 295 16. Ultrasound for procedure guidance 297 Introduction 297 Pleural effusion and thoracentesis 297 Ascites and paracentesis 301 Joint effusions and arthrocentesis 304 Foreign body identification/localization 308 Abscess drainage 315 Lumbar puncture 319 Pericardiocentesis 323 Detection of pacing capture 323 Bladder aspiration 323 Regional nerve blocks 327 References 334 Index 337 x Contents Contents
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Acknowledgments Many many thanks to the nurses, doctors, residents, and support staff in the emergency department at Massachusetts General Hospital. They make me a better doctor, keep me honest, and make it fun to come to work on most days. Thanks as well to Bret for his patience with both editions of this book and for being such a strong advocate for the field of point-of-care ultrasound. He never says no even if he probaby should – and thanks to Susan for letting him say yes. Finally a million thanks to Dr. Andrew Liteplo for being such a fabulous colleague – his enthusiasm for ultrasound knows no bounds, and many of the images in the book are from his collection. It is invaluable to have a colleague who shares my enthusiasm for the potential in point-of-care ultrasound and who works tirelessly supporting the education, research, and administrative efforts behind the advancement of the field. I am very lucky and grateful. VEN My wife Susan and son Holden give me the strength to work and the reason to come home. This book could not have been completed without their love and support. I am also grateful for Vicki’s tireless dedication to this book and the advancement of point-of-care ultrasound. Over the years I have been inspired by my colleagues, residents, and students to improve. Someday I just might.
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