By Zaid Altawil, MD
Faculty Advisor: Meera Muruganandan, MD
Few patients are as stressful as the patient in undifferentiated shock. With multiple organ systems generating a long list of differential diagnoses, it can be difficult to maneuver. Thankfully, we have some tools at our disposal. And as usual in Emergency Medicine, those tools involve some form of POCUS.
The RUSH exam, or Rapid Ultrasound for Shock and Hypotension, was a handy little pathway conceived by Weingart et al. to systematically run through the possible sources of shock and hypotension in a sick patient. It involves using the Curvilinear Array probe to cycle through nine views. The views themselves are not novel, but rather the approach combines multiple forms of studies in one pathway that is considered unique.
The above cheat sheet should serve as a quick reminder about the important views to cover when performing the RUSH exam. Its use is limited to physicians who have performed the exam before and have understood the literature, but want a quick reminder before doing it again.
For a more in depth view of the RUSH exam, feel free to review the references listed below! The PDF of this cheat sheet is downloadable at the link below:
Perera, Phillips, Thomas Mailhot, David Riley, and Diku Mandavia. 2012. “The RUSH Exam 2012: Rapid Ultrasound in Shock in the Evaluation of the Critically Ill Patient.” Ultrasound Clinics. doi:10.1016/j.cult.2011.12.010.
Scott D. Weingart, MD RDMS, Daniel Duque MD RDMS, Bret Nelson MD RDM.The RUSH exam: Rapid Ultrasound for Shock and Hypotension. . https://emcrit.org/rush-exam/