Archive April 2014 XV, No. 4

Anesthesia Alert: Are You Using Ultrasound to Its Full Potential?

How it's transforming anesthesia and perioperative care.

Susan Curling, MD, MBA

ultrasound to reduce or eliminate pain TRIPLE THREAT Ultrasound can help you reduce or eliminate pain before, during and after surgery.

When it was first suggested that we could use ultrasound for central line insertion, some fought tooth and nail to defend the traditional method: "I have my hands and landmarks, I should use them." Now, of course, ultrasound is mandated in most institutions for central line insertion.

Yet, physicians still occasionally argue against ultrasound's use. Usually, the last step needed to convince them comes when they watch as you insert a line without even looking at the skin. They see on the ultrasound screen as the needle smoothly and elegantly punctures and dives into the vein.

But that's just the beginning. The potential benefits and advantages of ultrasound go beyond what many realize. Along with providing freedom from pain during surgery, ultrasound is helping us ensure a less painful and safer experience both before and after procedures as well. At Memorial Hermann Hospital System in Houston, we've eliminated pneumothorax and almost eradicated incidental lacerations and punctures, in large part because of ultrasound.

Less pain before surgery
Can you provide patients with a pain-free experience, from the intravenous line insertion to the post-operative period? It's what all patients want, after all. An anesthesia team that uses ultrasound can help make the dream a reality.

For the many patients whose veins are difficult to access, ultrasound can help you identify otherwise hidden veins, decreasing the need for multiple painful sticks. We have nursing teams in the hospital that use ultrasound to start longer arm IVs (PICC lines), saving countless patients from the torment of multiple painful needle jabs. With ultrasound, even our most inexperienced physicians can insert central lines, on even our smallest patients, often with patients awake and sedated. It's faster and more effective: One study (tinyurl.com/pjg9yrr) found that ultrasound decreased complications during catheter placement and the need for multiple catheter placement attempts, compared with the standard landmark approach.

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