The main indication of the RUSH Ultrasound Exam is to quickly assess any patient with undifferentiated Shock and Hypotension.
Here is a simple to table that summarizes the pathology that may be encountered using the HI MAP Mnemonic of the RUSH Exam Ultrasound Protocol.
| Organ | Pathology | |
| H | Heart | Ejection Fraction (Reduced) -> Systolic Heart Failure Ejection Fraction (Hyperdynamic) -> Distributive or Hypovolemic Shock Pericardial Effusion -> Tamponade Right Ventricular (RV) Strain -> Pulmonary Embolism (PE) Regional Wall Motion Abnormality -> Myocardial Infarction Low Cardiac Output -> Cardiogenic, Hypovolemic, or Obstructive Shock High Cardiac Output -> Distributive Shock |
| I | Inferior Vena Cava (IVC) | IVC Collapsible -> Hypovolemic or Distributive Shock IVC Non-collapsible -> Obstructive or Cardiogenic Shock |
| M | Morison’s/eFAST Exam | Hemoperitoneum/Hemothorax -> Hemorrhagic Shock |
| A | Aorta | Abdominal Aortic Aneurysm Aortic Dissection |
| P | Pulmonary | Pneumothorax |
It is important to remember that the RUSH exam is not a comprehensive assessment of every component listed, but rather a quick evaluation for the major pathologies that can cause hypotension (and shock) in a patient. Once practiced, this exam can be completed in as little as 2-5 minutes.
Limitations faced by this protocol are those faced by any ultrasound examination: body habitus, patient positioning, and physical constraints that make ideal imaging difficult.