RT Book, Section A1 Boyd, Jeremy S. A1 Melton, Myles A1 Rupp, Jordan D. A1 Ferre, Robinson M. A2 Knoop, Kevin J. A2 Stack, Lawrence B. A2 Storrow, Alan B. A2 Thurman, R. Jason SR Print(0) ID 1181052190 T1 Ultrasound-Guided Resuscitation T2 The Atlas of Emergency Medicine, 5e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260134940 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181052190 RD 2024/11/05 AB As ultrasound is integrated into the bedside evaluation of many emergent symptoms and disease states, multiple protocols have emerged for the rapid assessment of critically ill patients in shock and cardiac arrest states. By combining many of the exams described previously in this chapter, one can quickly assess for the cause of a patient’s hypotension or cardiac arrest, helping to sort through what is often an extensive differential diagnosis. A common approach is termed the “RUSH” protocol—Rapid Ultrasound for Shock and Hypotension. Although there are distinct protocols proposed by different authors, they combine a sonographic assessment of a patient’s gross cardiac function, intravascular volume status, and identification of pathologic conditions (such as AAA or pneumothorax) that threaten a patient’s hemodynamic stability. One group of authors promotes the use of the heuristic “Pump, Tank, and Pipes” as the mental framework for this evaluation, while another uses the mnemonic “HI-MAP” (heart, IVC, Morison [and other FAST views], aorta, and pulmonary/pneumothorax) to outline the protocol. Regardless of which specific protocol one uses for evaluation of the hypotensive patient, when combined with a history and physical exam, bedside ultrasound can be used to guide resuscitative efforts and tailor them to the type of shock encountered.