Bedside Ultrasound in Resuscitation and the Rapid Ultrasound in Shock Protocol

Table 2

Using the RUSH protocol to diagnose the type of shock.

	Step no. 1	Step no. 2	Step no. 3
Pump	Pericardial effusion: (a) Effusion present?; (b) Signs of tamponade?; Diastolic collapse of R Vent +/− R Atrium?	Left ventricular contractility: (a) Hyperdynamic?; (b) Normal?; (c) Decreased?	Right ventricular strain: (a) Increased size of RV?; (b) Septal displacement; from right to left?
Tank	Tank volume: (1) Inferior vena cava: (a) Large size/small Insp collapse?; —CVP high—; (b) Small size/large Insp collapse?; —CVP Low—; (2) Internal jugular veins: (a) Small or large?	Tank leakiness: (1) E-FAST exam: (a) Free fluid Abd/Pelvis?; (b) Free fluid thoracic cavity?; (2) Pulm edema: Lung rockets?	Tank compromise: Tension pneumothorax?; (a) Absent lung sliding?; (b) Absent comet tails?
Pipes	Abdominal aorta aneurysm: Abd aorta > 3 cm?	Thoracic aorta aneurysm/dissection: (a) Aortic root > 3.8 cm?; (b) Intimal flap?; (c) Thor aorta > 5 cm?	(1) Femoral vein DVT?; Noncompressible vessel?; (2) Popliteal vein DVT?; Noncompressible vessel?