Ultrasound_for_Surgeons.pdf

LANDES

BIOSCIENCE

a d e m e c u

Ultrasound

for Surgeons

Heidi L. Frankel

vademecum

Ultrasound for Surgeons

Heidi L. Frankel, M.D., F.A.C.S.

Associate Professor of Surgery

Section of Trauma and Surgical Critical Care

Yale University

New Haven, Connecticut, U.S.A.

L A N D E S

B I O S C I E N C E

G EORGETOWN , T EXAS

U.S.A.

VADEMECUM

Ultrasound for Surgeons

LANDES BIOSCIENCE

Georgetown, Texas U.S.A.

No part of this book may be reproduced or transmitted in any form or by any

means, electronic or mechanical, including photocopy, recording, or any

information storage and retrieval system, without permission in writing from the

publisher.

Printed in the U.S.A.

Please address all inquiries to the Publisher:

Landes Bioscience, 810 S. Church Street, Georgetown, Texas, U.S.A. 78626

Phone: 512/ 863 7762; FAX: 512/ 863 0081

ISBN: 1-57059-597-6

Library of Congress Cataloging-in-Publication Data

Frankel, Heidi L.

Ultrasound for surgeons / Heidi L. Frankel.

p. ; cm. -- (Vademecum)

Includes index.

ISBN 1-57059-597-6

1. Ultrasonics in surgery. 2. Operative ultrasonography. I. Title.

II. Series.

[DNLM: 1. Ultrasonography--methods--Handbooks. 2. Surgical

Procedures, Operative--methods--Handbooks. WN 208 F828u 2004]

RD33.7.F73 2004

617'.07543--dc22

2003025277

While the authors, editors, sponsor and publisher believe that drug selection and dosage and

the specifications and usage of equipment and devices, as set forth in this book, are in accord

with current recommendations and practice at the time of publication, they make no

warranty, expressed or implied, with respect to material described in this book. In view of the

ongoing research, equipment development, changes in governmental regulations and the

rapid accumulation of information relating to the biomedical sciences, the reader is urged to

carefully review and evaluate the information provided herein.

Dedication

Dedicated to my husband, John,

and spouses like him, who allow us to practice our craft.

Contents

Foreword ......................................................................... 12

Acknowledgements ......................................................... 14

1. Education Credentialing and Getting Started:

With Attention to Physics and Instrumentation ............... 1

Vicente H. Gracias, Heidi Frankel and Ronald I. Gross

Historical Perspective .................................................................................. 1

Education in Surgeon-Performed Ultrasound: Training/Credentialing

and Practice Domains ......................................................................... 1

Credentialing in Ultrasound ....................................................................... 2

A Physics Primer ......................................................................................... 6

Appendix I. CESTE Guidelines Surgeon Eligibility

and Verification in Basic Ultrasonography .......................................... 7

Appendix II. Credentialing Requirements for Granting of Privileges

to Surgeons to Perform the Focused Abdominal Sonogram

in Reply To: Trauma (FAST) ............................................................... 9

General Principles ....................................................................................... 9

Training ...................................................................................................... 9

Maintenance of Qualifications .................................................................. 10

Use in the Emergent Setting

2. FAST (Focused Assessment by Sonography in Trauma) ... 11

Ronald I. Gross

History ..................................................................................................... 12

Technique: Performing the FAST Examination ......................................... 14

Advantages and Drawbacks of the FAST Examination .............................. 19

Application: Uses of FAST in the Acute Setting ........................................ 21

Future Applications of Ultrasound in the Acute Setting ............................ 24

Appendix I. Lectures for Postgraduate Course No. 23: Ultrasound

for the General Surgeon .................................................................... 26

3. Chest Trauma .................................................................. 30

Frank Davis and M. Gage Ochsner

Cardiac Injuries ........................................................................................ 30

Blunt Cardiac Injuries ............................................................................... 34

Traumatic Effusions (Hemothoraces) ........................................................ 35

Ultrasound Diagnosis of Pneumothorax ................................................... 37

TEE ......................................................................................................... 39

IVUS Assessment of Traumatic Injury to the Thoracic Aorta .................... 44

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