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? |