Daily Bolus of LR: RUSH Exam in Shock

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October 5, 2011 by dailybolusoflr

RUSH Exam or the Rapid Ultrasound in SHock Evaluation

This is a 3 part evaluation focused on cardiovascular etiologies that can be searched for with ultrasound in patients who are in shock.

The Pump- evaluating for the three following things 1. The pericardial sac for effusion and evidence of tamponade; 2. Global LV function; and 3. The relative size of the RV to the LV (increased size of the RV compared to the LV can be a sign of RV strain from PE)

The Tank- evaluating the IVC for intravascular volume status. IVC< 2cm and collapse with inspiratory sniff suggests a CVP< 10 cm H20. FAST should also be performed to evaluate for intra-abdominal and intra-thoracic volume loss and pneumothorax

The Pipes- Arterial- aorta for dissection or aneurysm; Venous- femoral/popliteal veins for DVT (suspect PE)

For a more detailed review of technique please read the article:
Perera P et al. Rapid Ultrasound in SHock in the Evaluation of the Critically lll. EMCNA 2010; 28: 29-56

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