Taming The SRU
Taming The SRU - December 21, 2020 - By Meaghan Frederick
"Ultrasound in Undifferentiated Hypotension
Point of care ultrasound (POCUS) can be a life saving, management changing tool in the care of critically ill patients. Multisystem POCUS can help emergency physicians quickly and accurately identify categories of shock, leading to more timely and more focused treatment(1, 2, 3). A multisystem study can be performed in a matter of minutes and help ED physicians distinguish between cardiogenic, obstructive, hypovolemic, and distributive shock.
While multiple variations of whole body ultrasound in shock have been proposed, The RUSH exam (Rapid Ultrasound for Shock and Hypotension) is commonly used. This includes evaluation of the heart, inferior vena cava (IVC), aorta, FAST abdominal views, and lung sliding (4). It is essentially the medical analog to the FAST exam (Focused abdominal sonography in trauma). The Mnemonic HI-MAP can help you remember the necessary views: Heart, IVC, Morrison’s pouch/FAST views, Aorta, and Pneumothorax. Remember, the goal of these views is to help you determine the category of shock, so that you can rapidly move to targeted treatment..."