Fundamentals of Point of Care Ultrasound Applications in Perioperative Settings

In anesthesiology, the use and application of ultrasound have expanded beyond conventional and sonoanatomical boundaries of vascular access, placement of invasive monitors, and placement of neuraxial and peripheral nerve blocks into more modern diagnostic arenas in the perioperative period. Ultrasound has emerged as an immensely valuable tool in guiding anesthesiologists in making significant practice changing decisions on treatment and therapeutic interventions. Ultrasound has far reaching influences regarding resuscitation, patient selection for surgery, and patient safety. Ultrasound has been hailed as the “21th century stethoscope” as it provides immediate, bedside, accessible, real-time, dynamic, and non-invasive data that echoes with rapid changes in clinical contexts or hemodynamic parameters (Gillman and Kirkpatrick, Scand J Trauma Resusc Emerg Med. 20:18, 2012). This chapter will highlight brief overviews of ultrasound applications and developments in various perioperative settings and their relationships with focused clinical contexts. These include: gastric ultrasound and preoperative fasting, lung ultrasound and concerns for oxygenation and ventilation, focused cardiac ultrasound and hemodynamic instability, as well as other applications such as airway or FAST exams in airway and trauma management.