RUSH to Resus: Components of the RUSH Exam

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Picture of Mohamed Hagahmed, MD, EMT-P
Mohamed Hagahmed, MD, EMT-P
Mohamed is an Emergency Medicine Physician and EMS director. His main areas of interest are Critical Care, Ultrasound, Prehospital Resuscitation, and Medical Education. Find him on Twitter @HagahmedMD

When you are unsure of why your patient is hemodynamically unstable, use the RUSH exam: Rapid Ultrasound for Shock and Hypotension. Using the curvilinear or phased array probes, obtain these views to look for potential causes:

I. Pump: Evaluate the pericardium for Tamponade/Effusion, LV size for failure / cardiogenic shock, and RV size for failure/PE.

(1) Parasternal Sternal Long Axis view

(2) Apical 4-chamber view

II. Tank

(3) Inferior Vena Cava view

Collapsible → Hypovolemic shock

Plethoric → Cardiogenic shock/failure or Obstructive shock/PE

(4) Morrison pouch with hemothorax view

(5) Splenorenal recess with hemothorax view

(6) Bladder – Free fluid or blood

(8) & (9) Lung views – Tension Pneumothorax, effusion

III. Pipes

(7) Aortic views – AAA, rupture, dissection / Long and short-axis views

Note: If clinical suspicion is high, consider evaluating for ectopic pregnancy or DVT.

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