Book Review – Focussed Intensive Care Ultrasound!

Who are the authors?

Dr Pete MacNaughton

Image result for peter mACNAUGHTON itu consultant

Qualifications: BSc, MB.BS, MD, MRCP, FRCA, PGCert Ed.

General information:

Dr MacNaughton qualified from Westminster Medical School, University of London in 1982. He undertook his postgraduate training in Anaesthesia and Intensive Care Medicine in London, Bristol and Australia. This was followed by MCRP Training Fellowship between 1989-1991 at National Heart and Lung Institute, Royal Brompton Hospital, London.

Dr MacNaughton was appointed Consultant in Anaesthesia and Intensive Care Medicine in 1995. He was an elected member of the Council Intensive Care Society (2004-2010) and the Board of the Faculty in Intensive Care Medicine (2014 – present). Peter is also the chair of the FICM Professional Standards Committee (2016 – current).

 

Dr Marcus Peck 

Marcus Peck

@ICUltrasonica

Marcus is one of our fellow Ultrascoundrels and one of the nicest fellows out there! He is extremely handy with an ultrasound probe! He is currently on the ICS council and chairs the FICE committee. He is a consultant in Anaesthesia and ITU at Frimley Park Hospital.

 

Introduction

Point of Care Ultrasound (POCUS) is an area of rapid growth and development in the critically ill, and especially in the UK. There have been a number of seminal textbooks looking at a “whole body” approach to POCUS, but none from the UK.

This book- from a collection of UK POCUS illuminaries- fills that gap, and more.

My review is based on the online version of this- which has access to videos, MCQs and more.

 

Structure

A hefty TOC!

Screenshot 2019-10-23 at 15.11.07

It is split into 5 sections- ultrasound, structure, procedure, problem, and governance- which allows the reader to choose how they want to learn POCUS, and which aspects they would like to focus on each time they read. I really like this layout- it allows you to find exactly what you want anytime you’re looking for it. Importantly, this book covers whole-body ultrasound, and covers lung, abdominal, vascular (both DVT and vascular access) and airway ultrasound- amazing!

 

Content and Style

The book is written as a gentle introduction to focused ultrasound but does introduce intermediate and advanced level concepts as the reader delves further. The chapter on “Left Ventricular assessment”, for instance, starts off with “eyeball” assessments, and then gradually introduces 2D measurements and goes all the way up to a brief discussion on tissue Doppler. Despite the variety of authors, the overall style of the text is consistent, and it stays easy to read throughout.

The “Problem Based” sections focus on practical “No frills” techniques to optimise your care of the critically unwell patient. I really enjoyed the sections on shock and cardiac arrest- they demonstrated both the usefulness of POCUS in these circumstances, but also discussed the many pitfalls.

Importantly, it has a chapter devoted to “Governance”- very relevant in the current UK environment. Training pathways and requirements for focused ultrasound are delineated, as well as suggestions for maintaining standards.

Images

High-quality images are included throughout the text. My online version had access to the videos- which are similarly great, and illustrate technique/pathology really well. There are also plenty of them!

Feel

Reading the text felt like having a bunch of POCUS experts talking to me and demonstrating techniques! I really enjoyed it and could digest two or three chapters at a time.

Drawbacks

As great as this book is, it’s not perfect. Point of care ultrasound for neurological assessment is probably the most glaring omission (so no ONSD or TCD- one for the next edition of the book chaps?). I’d have liked to see a little bit on basic regional anaesthesia for the intensivist- the vast majority of ICM trainees in the UK are from an anaesthesia background still, and this would be helpful.

 

Conclusion

I have read a lot of POCUS textbooks and this is in my top 3 (Lumb’s Critical Care Ultrasound is probably still my favourite). It is definitely the premier UK textbook on POCUS right now, and I think that every intensive care unit in the UK should have one of these in the office (or ideally attached to each machine!).

My one question is, when’s the Advanced Ultrasound Textbook coming out chaps?

Segun’s rating – 9.5/10!!

Review by Dr Segun Olusanya

Segs.png

Segun is an Intensive Care Trainee in the London Deanery. He completed his medical school training in Southampton and has trained in medicine, anaesthesia and intensive care medicine in the Thames Valley and in London. A keen supporter of #foamed, he is on the organising committee of the ICS State of the Art Meeting, an editor for the Bottom Line and Life in the Fast Lane, and an associate editor of JICS.

His other interests include Point of Care Ultrasound (Obviously!) and doctors wellbeing. He also runs the company monanniecakes.com along with his wife and enjoys eating the leftover desserts.

Buy it here!

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Screenshot 2019-10-23 at 15.17.42

 

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