Skip to main content Accessibility help
×
Home
Hostname: page-component-544b6db54f-6mft8 Total loading time: 0.437 Render date: 2021-10-18T20:23:33.095Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Book contents

32 - Ultrasound Procedures in Trauma

Published online by Cambridge University Press:  18 January 2010

Paul Soeding
Affiliation:
Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia
Peter Hebbard
Affiliation:
Department of Anaesthesia and Pain Management, Department of Pharmacology, Northeast Health Wangaratta, School of Rural Health University, Melbourne, Victoria, Australia
Charles E. Smith
Affiliation:
Case Western Reserve University, Ohio
Get access

Summary

Objectives

  1. Identify the role of ultrasound in trauma.

  2. Understand the technique of neurovascular examination.

  3. Identify normal neurovascular appearance and injury.

  4. Understand ultrasound-guided regional anesthesia.

  5. Understand ultrasound-guided vascular cannulation.

SUMMARY

Ultrasound examination plays an increasingly important role in trauma management and anesthesia. Sonographic examination of peripheral nerves and vasculature can not only assess injury, but also guide needles for vascular access and regional anesthesia. Ultrasound-guided cannulation of arteries and veins allows invasive hemodynamic monitoring and fluid resuscitation in the trauma patient. Regional anesthesia provides immediate analgesia of injured limbs and enables specific surgical intervention. This chapter focuses on neurovascular anatomy and its recognition by ultrasound. The examination and identification of individual sonoanatomy is the basis for all ultrasound-guided procedures.

INTRODUCTION

The recent development of portable high-frequency ultrasound units has made ultrasound examination an important component in the assessment of the trauma patient. Trauma management requires both resuscitation and careful systematic assessment of individual wounds, both evident and suspected. Injury, however, can often be difficult to evaluate, especially when injury is concealed, such as in the case of blunt abdominal trauma or neurovascular injury associated with limb fractures. Sonography can be applied first as a diagnostic tool in the individual patient, and second, as a guide in therapeutic procedures [1].

Focused sonographic examination of the chest and abdomen can identify internal organ injury and hemorrhage, while examination of injured limbs can identify underlying musculoskeletal injury.

Type
Chapter
Information
Trauma Anesthesia , pp. 499 - 513
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Marhofer, P, Greher, M, Kapral, S. Ultrasound guidance in regional anaesthesia. Br J Anaesth 2005; 94(1): 7–17.CrossRefGoogle ScholarPubMed
Plunkett, AR, Brown, DS, Rogers, JM, et al. Supraclavicular continuous peripheral nerve block in a wounded soldier: when ultrasound is the only option. Br J Anaesth. Nov 2006; 97(5): 715–7.CrossRefGoogle Scholar
Soeding, PE, Sha, S, Royse, CE, Marks, P, Hoy, G, Royse, AG. A randomized trial of ultrasound-guided brachial plexus anaesthesia in upper limb surgery. Anaesth Intensive Care 2005; 33(6): 719–25.Google ScholarPubMed
Gray, AT. Ultrasound-guided regional anesthesia: current state of the art. Anesthesiology 2006; 104(2): 368–73.CrossRefGoogle ScholarPubMed
Koff, MD, Cohen, JA, McIntyre, JJ, et al. Severe brachial plexopathy after an ultrasound-guided single-injection nerve block for total shoulder arthroplasty in a patient with multiple sclerosis. Anesthesiology 2008; 108: 325–8.CrossRefGoogle Scholar
Moayeri, N, Bigeleisen, PE, Groen, GJ. Quantitative architecture of the brachial plexus and surrounding compartments, and their possible significance for plexus blocks. Anesthesiology 2008; 108: 299–304.CrossRefGoogle ScholarPubMed
Peer, S, Bodner, G, Meirer, R, Willeit, J, Piza-Katzer, H. Examination of postoperative peripheral nerve lesions with high-resolution sonography. AJR Am J Roentgenol 2001; 177(2): 415–9.
Bodner, G, Buchberger, W, Schocke, M, Bale, R, Huber, B, Harpf, C, Gassner, E, Jaschke, W. Radial nerve palsy associated with humeral shaft fracture: evaluation with US – initial experience. Radiology 2001; 219(3): 811–6.CrossRefGoogle ScholarPubMed
Meissner, M, Paun, M, Johansen, K. Duplex scanning for arterial trauma. Am J Surg 1991; 161(5): 552–5.CrossRefGoogle ScholarPubMed
Chapman, GA, Johnson, D, Bodenham, AR. Visualisation of needle position using ultrasonography. Anaesthesia 2006; 61(2): 148–58.CrossRefGoogle ScholarPubMed
Sandhu, NS, Capan, LM. Ultrasound-guided infraclavicular brachial plexus block. Br J Anaesthesia, 2002; 89(2): 254–9.CrossRefGoogle ScholarPubMed
Royse, CE, Sha, S, Soeding, PF, Royse, AG. Anatomical study of the brachial plexus using surface ultrasound. Anaesth Intensive Care 2006; 34(2): 203–10.Google ScholarPubMed
Marhofer, P, Schrogendorfer, K, Koinig, H, Kapral, S, Weinstabl, C, Mayer, N. Ultrasonographic guidance improves sensory block and onset time of three-in-one blocks. Anesth Analg 1997; 85: 854–7.CrossRefGoogle ScholarPubMed
Chan, VWS, Nova, H, Abbas, S, McCartney, CJL, Perlas, A, Xu, D. Ultrasound examination and localization of the sciatic nerve: a volunteer study. Anesth 2006; 104: 309–14.CrossRefGoogle ScholarPubMed
McDonnell, JG, O'Donnell, B, Curley, G, Heffernan, A, Power, C, Laffey, JG. The analgesic efficacy of transversus abdominis plane block after abdominal surgery: a prospective randomized controlled trial. Anesth Analg 2007 Jan; 104(1): 193–7.CrossRefGoogle Scholar
Hebbard, P. Audit of “rescue” analgesia using TAP block. Anaesth Intensive Care 2007; 35(4): 617–8.Google ScholarPubMed
Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment. No. 43. Making Health Care Safer: A Critical Analysis of Patient Safety Practices. Chapter 21. Ultrasound Guidance of Central Vein Catheterization. Available at: www.ahrq.gov/clinic/ptsafety/chap21.htm.
National Institute for Clinical Excellence. TA49 Central venous catheters – Ultrasound locating devices: Guidance www.nice.org.uk/page.aspx?o=TA049guidance.

Send book to Kindle

To send this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Ultrasound Procedures in Trauma
    • By Paul Soeding, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia, Peter Hebbard, Department of Anaesthesia and Pain Management, Department of Pharmacology, Northeast Health Wangaratta, School of Rural Health University, Melbourne, Victoria, Australia
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.035
Available formats
×

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

  • Ultrasound Procedures in Trauma
    • By Paul Soeding, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia, Peter Hebbard, Department of Anaesthesia and Pain Management, Department of Pharmacology, Northeast Health Wangaratta, School of Rural Health University, Melbourne, Victoria, Australia
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.035
Available formats
×

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

  • Ultrasound Procedures in Trauma
    • By Paul Soeding, Department of Anaesthesia and Pain Management, Department of Pharmacology, Royal Melbourne Hospital, University of Melbourne, Carlton, Victoria, Australia, Peter Hebbard, Department of Anaesthesia and Pain Management, Department of Pharmacology, Northeast Health Wangaratta, School of Rural Health University, Melbourne, Victoria, Australia
  • Edited by Charles E. Smith, Case Western Reserve University, Ohio
  • Book: Trauma Anesthesia
  • Online publication: 18 January 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547447.035
Available formats
×