Book review – SCAN-IT: A Primer for Emergency Point of Care Ultrasound

Here we bring you another review of a text on POCUS….of course! This comes from the delightful POCUS ninja, Dr Manoj Wickramasinghe.

Thanks to him, so what is out and what did he think?

About the authors:

Muhammad Akbar Baig is an Assistant Professor and consultant in Emergency medicine with specific interests in research, critical care and resuscitation.

Sadaf Sheikh is working as a specialist in Emergency medicine and her interests include research, critical care and international emergency medicine

Introduction

There is no argument that Point of Care Ultrasound (POCUS) has taken off in the last decade! There is a huge body of literature and evidence for POCUS and following this, a few comprehensive whole-body PoCUS books have been released – this is one of them!

Structure and style

This book has 14 different chapters. Mostly split into body systems with 2 miscellaneous chapters (ultrasound guided procedures and nerve blocks). Each chapter has a universal structure within it:

Introduction
Patient positioning
Probe selection
Windows
Pathology and pitfalls

This universal structure makes the book quite an easy read, as you know how each chapter is going to unfold. I particularly like the pitfalls section, which is clearly so crucial for POCUS.

Content

Reading this book is such a tease! It is clearly designed as a general guide to POCUS, hence some of the sections are very brief. I would have liked to see a little more detail in many.

Doppler in echocardiography (colour, pulse-wave or continuous), stroke volume assessment, basic valvular assessment, TAPSE, dynamic/static air bronchograms, visualising and measuring aortic bifurcation for aneurysms, appearance of necrotiscing fasciitis on ultrasound, bladder volume calculation, grading hydronephrosis, erector spinae/serratous anterior blocks, dynamic vs static techniques for thoraco/para/pericardiocentesis are a few (but not all), of the things that are unfortunately not covered. I was also very surprised VEXUS was not mentioned, given the sheer amount of hype it has had in recent years.

Having said this, I really like the sheer breadth of topics (albeit briefly), covered in this book. They are all definitely relevant to Emergency Physicians. It is certainly an impressive feat to fit this much into what is actually a short read.

The beginning of the book has a very nice section on ultrasound physics and knobology. I think the level of detail in this particular section is perfect – not too much that you are lost or falling asleep, but just enough so it covers the most important concepts.

I was a little disappointed to spot a few typo’s and mistakes on just one read. A few examples below:

This is right lateral position – not ‘left lateral’, and is certainly not ideal for cardiac windows!

Should say screen, not ‘scree’

Should say 10-12cm, not ’10-12mm’

I think I am being harsh and picky with these typos but for me they question the amount of thought process and deliberation that has been put into anything else that I read within the book.

Images

POCUS is all about pattern recognition and that makes image/video quality of POCUS related education crucial. The image quality in this book is a bit of a mixed bag. Some sections have excellent images – particularly musculoskeletal and nerve blocks. However, the general quality of the images shared in the book, in my opinion, are not of high standard. It is so important to have really good images when trying to teach and I don’t think these images do that. A couple of examples below:

An example of a B-line, it looks like a B-line, but the definition is so poor you can’t even discern the pleural line?

An example of a subcostal view – the orientation is the opposite side to what the majority of people use (well certainly in the UK anyway) and again, not the best quality with the right atrium barely visible. This is probably going to be sufficient for a specific clinical question like ‘is there tamponade?’, but not an ideal image for teaching purposes.

Conclusion

A relatively short book that covers a lot of different PoCUS body systems in brief detail. Generally, it does a good job of giving the novice scanner an idea of what can be scanned and how. This book is most definitely marketed towards beginners in POCUS who want to get a general idea of what POCUS brings to the table (beyond IV access). So, if you are pretty PoCUS savvy, then this may not be the book for you.

In my personal opinion, this book is a little too brief and the image quality is not adequate enough to act as the primary educational resource for someone learning POCUS. It also does not bring anything particularly new to the table and for that reason, Lumb’s critical care ultrasound and Focussed Intensive Care Ultrasound are unmoved as my two favourite POCUS books.