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The Rapid Ultrasound in Shock (RUSH) Exam
- Evaluating the ED patient with undifferentiated shock can be challenging.
- Ultrasound can be an invaluable tool in helping to differentiate between hypvolemic, cardiogenic and obstructive shock.
- The RUSH exam essentially focuses on the evaluation of the "pump", the "tank" and the "pipes".
- The pump: exclude pericardial effusion, global estimate of LV EF, and determine if RV strain is present.
- The tank: evaluate the IVC/jugular veins for volume status, look for fluid in the thorax/peritoneum, and exclude pulmonary edema or pneumothorax.
- The pipes: look for a ruptured AAA or aortic dissection and DVT.
References
Perera P, Mailhot T, Riley D, Mandavia D. The RUSH Exam: Rapid Ultrasound in Shock in the Evaluation of the Critically Ill. Emerg Med Clin N Am 2010; 28:29-56.