This document discusses the use of ultrasound in evaluating patients in shock. It reviews the different types of shock and introduces the RUSH protocol, which uses ultrasound to rapidly evaluate the heart ("the pump"), blood volume ("the tank"), and blood vessels ("the pipes"). Ultrasound can quickly identify issues like tamponade, low heart function, blood clots, and pneumothorax that may be causing shock. The document advocates ultrasound as a useful tool for rapid evaluation of critically ill patients in shock.

1. ULTRASOUND IN SHOCK
Anu Mascarenhas

2. OBJECTIVES
• Review the
definition of shock
and its forms
• Highlight the
usefulness of
Ultrasound in shock

3. PLAN
• Lecture
• Practical session

4. SHOCK
• Def: Absolute or relative circulatory failure resulting
inadequate tissue perfusion.

5. SHOCK
• Hypovolemic
• Distributive
• Cardiogenic
• Obstructive

6. RUSH
• Rapid Ultrasound for SHock

7. 3 PARTS
• The Pump
• The Tank
• The Pipes
• Heart
• Blood Volume
• Blood Vessels

8. THE PUMP
• Tamponade
• LV function
• Right Ventricular
Enlargement
• Parasternal Long
• 4 Chamber view

11. THE TANK
• Fullness
• Leakiness
• IVC
• Morrisons Pouch

15. THE PIPES
• Rupture
• Clogging
• Aorta
• Pneumothorax
• DVT

19. SUMMARY
• US offers quick evaluation

20. QUESTIONS
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21. REFERENCE
• Rush protocol:
• The RUSH Exam: Rapid Ultrasoundin SHock in the
Evaluation of the Critically l l l. Phillips Perera, RDMS,
Thomas Mailhot, David Riley, Diku Mandavia,
• http://emcrit.org/rush-exam/
• http://lifeinthefastlane.com/own-the-echo/
• Other:
• http://lifeinthefastlane.com/smacc-the-dark-art-of-ivc-
ultrasound/
• http://www.ultrasoundvillage.com/educationresour
ces/modules/?module=8