The RUSH Exam: Rapid Ultrasound for Shock and Hypotension
Scott D. Weingart, MD RDMS, Daniel Duque MD RDMS, Bret Nelson MD RDMS
Hear the Lecture
This concept was first conceived by the authors above in 2006 and discussed in national lectures in 2007 and on. It has been available on emcrit.org since March 2008 and was the first hit on a google search of ‘RUSH Exam' from this date on. It was published on Emedhome in May 2009.
Expanded RUSH Exam
HI MAP ED
Two additions based on the results of the initial HI MAP:
Ectopic-look for the actual extra-uterine pregnancy
DVT-Multi-site search for DVT. If found in the setting of SOB or right heart enlargement, PE should be considered diagnosed.
Original RUSH Article
- This article on the RUSH Exam was published in May 2009
Jacob's Take from 5-Minute Sono
Additional Resources for the RUSH Exam
- Newest RUSH Review (Critical Care Research and Practice 2012;doi:10.1155/2012/503254)
- An article on the benefits of multiorgan ultrasound in shock patients (Inten Care Med PMID: 23584471)
- Goal-directed echocardiography from Mayo and Koenig (CHEST 2012; 142 ( 4 ): 1042 – 1048)
- Prospective Cohort Trial in the ED with extensive POCUS protocol (Intens Care Med 2013;39:1290)
- Bedside Ultrasound Reduces Diagnostic Uncertainty and Guides Resuscitation in Patients with Undifferentiated Hypotension (CCM 2015;43(12):2562)
- SHOC-ED showed no change compared to standard assessment, but yet again, lacked the diagnoses that RUSH picks up and changes management [Canadian Journal of Emergency Medicine volume 25, pages48–56 (2023)]
- Teaching RUSH to Med Students
Thank you
THANK YOU
Thank you so much Scott. Your breakdown of the Rush exam (amongst other work you have published) is helping me:
1) better understand and use US in the ED
2) compile my research protocol on US of IVC in the positively ventilated- is it still reliable as a preload surrogate?
Ta
Oh oh, is it just me or is the lecture recording not working?
Just you I think, try a different browser. All is working.
s
Do you have a video of this talk, or a copy of the slides used?
Do you teach this concept in your ED? Can you give any details about the course format? Thank you. Ingo Gräff, MD, head ED, University Bonn, Germany
Does anyone have a good suggestion for a beginner-intermediate ultrasound course? I am faculty with a family medicine residency and also work as a hospitalist and do rural ED moonlighting. So, I have somewhat broad needs.
Thanks!
Emily
Instructor, KUSM-Wichita
Gulfcoast Ultrasound Institute, the best beginner and advanced live and online courses
ultrasonidoc
Pienso que la utilidad del ultrasonido es muy amplia y fácil de aplicar, no obstante no siempre esta disponible en todos los centros o servicios de urgencia. Los protocolos son claros y significativos al momento de tomar las mejores desiciones.
Than you. I am learning a lot
Good Afternoon, I work in Mount SInai ED Coding department. Our provider did a RUSH/Shock POCUS in ED; what is the correct CPT to submit to the insurance company?
To bill this exam, you can generate codes for:
Limited Echo: CPT 93308
FAST Exam: 76705
Aorta: 76706
and
Lung Ultrasound: 76604
Hi, 3 related questions regarding utility and sensitivity of FAST for hemorrhage 2/2 pelvic fracture:
1) Is the FAST scan sensitive for pelvic fracture hemorrhage, given that such hemorrhage is often intraperitoneal and/or retroperitoneal?
2) Is the bladder view sensitive for infraperitoneal hemorrhage (obviously it is not for retro hemorrhage).
3) Dr. Weingart has discussed the disproportionately high sensitivity of the RUQ in Trendelenburg relative to the other views; should this thought process be dismissed in patient with possible pelvic hemorrhage, given that the bleed may be intraperitoneal?
[…] 10.Weingart S, Duque D, Nelson B. Rapid Ultrasound for Shock and Hypotension – the RUSH Exam. EMCrit. May 2009. Accessed January 9, 2024. https://emcrit.org/rush-exam/ […]