role of rapid ultrasound in shock( Rush) schedule differential diagnosis role of emergency ultrasound in ER different types of shock

1. ‫هللا‬ ‫بسم‬
‫الرحيم‬ ‫الرحمن‬

2. Dr. Ahmed Eisawy
MBBS M.Sc MD

3. FULL STORY
OF
RUSH

4. RUSH Rapid ultrasound in shock
cardiogenic hypovolemic
Obstructive
Relative
(distributive)
Sepsis
Adrenal insufficiency
Neurogenic shock
Vasoplegic states
Absolute
Haemorrhage
Dehydration
GI or renal loss
Diastolic dysfunction
Hypertention
tachycardia
Systolic dysfunction
Structural
Valve pathology
regional
ischemic
Global
Cardiomypoathy
takotsubo
PE
Tension PTXHOCM
With SAM
Tamponade
Massive pleural
effusion and Ascites

5. Rapid Ultrasound in Cardiogenic shock
Diastolic dysfunction
Hypertention
tachycardia
Systolic dysfunction
Structural
Valve pathology
regional
ischemic
Global
Cardiomypoathy
takotsubo
Qualitative LV
Mitral valve hitting septum
LV wall thickening and moving
Plethoric IVC
B LINES
RV strain
RV size
function

6. Rapid ultrasound in hypovolemic shock
Relative
(distributive)
Sepsis
Adrenal
insufficiency
Neurogenic shock
Vasoplegic states
Absolute
Haemorrhage
Dehydration
GI or renal loss

7. Hypovolemic shock
Static
parameters
Dynamic
parameters
Passive leg raiseIVC
distensibility index
CVP
IVC diameter
LVEDD
LVADA
DeltaVTI DeltaVMAX
hyperdynamic
kissing papillary sign
IDI =

8. Rapid ultrasound in Obstructive shock
PE
Tension
PTX
HOCM
With SAM
Tamponade
Massive pleural
effusion and
Ascites

9. RUSH Rapid ultrasound in shock
PUMP TANK
PIPES
IVC variation
Tank
compromise
LV contractility
Right ventricular strain
Pericardial
effusion
Leaks
Holes in the tank
DVT
Aortic
dissection
Aneurysm

10. Cardiogenic shock
LV
Qualitative LV
RV strain
RV size
function
Mitral valve hitting septum
LV wall thickening and moving
Plethoric IVC
B LINES

11. LV function
 Mitral valve hitting septum
 LV wall thickening and moving
 Plethoric IVC
 B LINES