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Focused Cardiac Ultrasound in Shock (RUSH Protocol)

Bedside ultrasound differentiation of shock subtypes substantially changes management.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Focused Cardiac Ultrasound in Shock (RUSH Protocol)?

The RUSH (Rapid Ultrasound for Shock and Hypotension) protocol enables rapid bedside assessment of cardiac function, volume status and the vascular system in patients with shock.

Pump (heart), Tank (IVC, lungs, FAST) and Pipes (aorta, DVT) components are examined sequentially. Most causes of shock can be identified within 10 minutes.

Early accurate diagnosis reduces mortality and individualises fluid and vasopressor therapy.

Symptoms

Hypotension
Tachycardia
Cold, clammy skin
Prolonged capillary refill
Oliguria
Altered consciousness
Rising lactate
Low ScvO2

Risk Factors

Trauma
Sepsis
Heart failure
Pulmonary embolism
Tamponade
Severe anaphylaxis
Major volume loss
Adrenal insufficiency

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Patients with hypotension and altered consciousness need rapid evaluation
  • Tachycardia and oliguria are early warning signs
  • Cold extremities and mottling are signs of shock
  • Pre-arrival emergency notification (call 112 in Turkey)

Treatment Methods

01
Activate the team and start monitoring
02
Apply the RUSH protocol
03
Pump: contractility, tamponade, LVEF
04
Tank: IVC filling, lung B-lines, FAST
05
Pipes: AAA, aortic dissection, deep vein thrombosis
06
Initiate cause-directed therapy
07
Individualise choice of fluid, vasopressor and inotrope
08
Monitor response with serial assessment
09
Prepare transfer to intensive care
10
Document findings and conduct teaching

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.