Difference between revisions of "Ultrasound: In Shock and Hypotension"
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Rapid Ultrasound for Shock and Hypotension (RUSH) using the HI-MAP approach | Rapid Ultrasound for Shock and Hypotension (RUSH) using the HI-MAP approach | ||
− | + | ==Heart== | |
− | + | *Pericardial Effusion | |
− | == | + | **Parasternal long |
− | + | **Change in size <30% between sys and dia = poor LV function | |
− | + | *RV collapse | |
− | + | **In 4-chamber view, RV should be <60% of LV; if larger think RV failure | |
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− | + | ==IVC== | |
+ | *Measurae 2cm from RA-IVC junction | ||
+ | *If IVC <1.5cm and collapses on inspiration then CVP is low | ||
+ | *If IVC >2.5cm and noncollapsing then CVP is high | ||
+ | **Suggests fluid unresponsive; pt requires inotropes | ||
+ | ==Morison's== | ||
+ | *Look for fluid at lung/diaphragm interface | ||
+ | ==Aorta== | ||
+ | *If >5cm assume ruptured AAA until proven otherwise | ||
− | == | + | ==Pulmonary== |
− | + | *Assess for PTX by scanning longitudinally in anterior 3rd IC space | |
− | + | **Look for lack of sliding or use M-mode to look for reassuring beach sign | |
− | PTX | ||
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==Source== | ==Source== | ||
− | + | Weingart - http://emcrit.org/ultrasound/The%20RUSH%20Examfinal.htm | |
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[[Category:Rads]] | [[Category:Rads]] |
Revision as of 02:09, 11 May 2011
Rapid Ultrasound for Shock and Hypotension (RUSH) using the HI-MAP approach
Contents
Heart
- Pericardial Effusion
- Parasternal long
- Change in size <30% between sys and dia = poor LV function
- RV collapse
- In 4-chamber view, RV should be <60% of LV; if larger think RV failure
IVC
- Measurae 2cm from RA-IVC junction
- If IVC <1.5cm and collapses on inspiration then CVP is low
- If IVC >2.5cm and noncollapsing then CVP is high
- Suggests fluid unresponsive; pt requires inotropes
Morison's
- Look for fluid at lung/diaphragm interface
Aorta
- If >5cm assume ruptured AAA until proven otherwise
Pulmonary
- Assess for PTX by scanning longitudinally in anterior 3rd IC space
- Look for lack of sliding or use M-mode to look for reassuring beach sign
Source
Weingart - http://emcrit.org/ultrasound/The%20RUSH%20Examfinal.htm