Understanding the RUSH Exam

First introduced in 2006 by Weingart SD, the RUSH (Rapid Ultrasound in SHock) exam has been instrumental in the early evaluation of a hypotension or shock. It was designed to be used with the portable ultrasound machines found in the majority of emergency room and critical care facilities. The RUSH approach is used to examine the heart, inferior vena cava, Morison’s/FAST abdominal views with thoracic windows, aorta, and pneumothorax scanning.

Because understanding RUSH is so important, National Ultrasound was recently a part of a webinar hosted by GE and led by renown Professor of Emergency Medicine, Dr. Christian Fox, shared updates and instruction for managing critically ill patients.

There are several components of a RUSH exam, and each play an important part in ascertaining a patient’s status. These following 6 areas are included in RUSH:

Heart

During a RUSH exam, the heart is checked for ventricular failure or an assessment of the functionality. Echocardiographic views of the heart’s 4 chambers give the doctors more information so they know how best to proceed.

Pericardial Tamponade

When one is in shock or experiencing hypotension, there is more pericardial fluid which can cause one to suspect pericardial tamponade. However, by using RUSH, one can determine more specifically if there is a collapse in the right atrium during diastole and the right ventricle during early diastole. If tamponade is determined, then the ultrasound will also be able to detect pericardiocentesis.

Right Ventricular Enlargement

An enlarged right ventricle often occurs when one goes into shock, and a RUSH exam will identify this sooner rather than later. Should the right ventricle (RV) size equal or be large than the left, then chances are the right ventricle has failed; however, the problem may also be due to right ventricle infarction. Again, the ultrasound will make a determination of cause much quicker and clearer.

Hypodynamic Left Ventricle

In the case of hypotension, assessing the left ventricle (LV) can determine if the problem is due to infarction or myopathy, or a secondary problem such as sepsis or toxins.  As one uses the RUSH ultrasound approach, it becomes easier and faster to identify what problem needs to treated.

Hyperdynamic Left Ventricle

If during an echocardiogram, it is determined that the left ventricular walls change by more than 90% or if they actually touch at the end systole, then the LV is hyperdynamic.  This is also seen in hypovolemia, acute blood loss, and often in sepsis prior to the administration of vasopressors.

Inferior Vena Cava

The RUSH evaluation can also determine the volume status of the patient based on filling pressures during respiration. The examine will be done differently, depending on whether the patient is spontaneously breathing or receiving mandatory breaths from a ventilator.

Caring for a patient with shock can be one of the most challenging jobs in the ER medicine, and being able to make a quick assessment is a must. Understanding fully how to implement the RUSH exam approach has saved countless lives in the last decade.

If you have questions about RUSH or how to use with your specific type of ultrasound, then don’t hesitate to contact National Ultrasound or spend some time listening to the recent webinar hosted by GE.

Getting to Know the Vscan!

GE-Vscan-Extend-Dual-Probe-for-cardiovascular-applications

National Ultrasound is always happy to introduce new equipment that helps to advance the medical field and help people live longer, fuller lives. One of the most recent machines in our product line is the GE Vscan Extend Dual Probe. This ultrasound machine can be used for many scenarios, thus making medicine and treatment options better. The Vscan is especially helpful in ascertaining those issues related to the bladder but can be used for other determinations as well.

Although bladder issues are most common for people between the ages of 60 and 80, they can also affect people as early as their mid 20s. The Vscan makes detection easier so the sooner the problems are identified and treatment begun, the fuller life one can live.  After all, no matter the age, no one wants to live in pain or discomfort ,and the Vscan’s ease of use makes it the perfect diagnostic tool. Not sure if the Vscan will benefit your practice? Then check out these great features:

·      The Vscan provides a simple, fast, and precise evaluation –often giving results within the hour.

·      It works with the DICOM and PACS to provide an image or to upload your new images into the system so that they can accessed at both your clinic or at the hospital.

·      It can quickly scan the bladder, gallbladder, aorta, kidney, liver or spleen.

·      It has a dual probe with both linear and phase away options.

·      Unlike other ultrasound machines of this nature which only have an orbital probe used to measure longitudes and sagittal results, the Vscan does a more thorough examination that results in better picture quality.

·      The GE Vscan Extend Dual Probe has a 3-year warranty.

·      It is easy to clean because the cable, probe and system itself are all one piece.

·      It starts with just the touch of a button and quickly connects with the Vscan extend.

·      The images are clear and easily read.

·      It works with several apps such as the Bladder Volume and the Lung Protocol.

·      It works with a cloud ecosystem thus making it easy to access workflow, reports, and triage applications.

·      It is totally portable. In fact, it is nearly the same size as your cell phone, and can even be used when out in the field to ascertain any problems, which makes ideal for clinicians, military medics, or physicians who are on hand at sporting events.

·      Not only is it effective on the scene of an emergency, but it can also be used when en route to a medical facility.

The GE Vscan is a great addition to any medical facility due to its portability, ease of use and clear images. Don’t put off getting the Vscan for your health care location. Give the team at National Ultrasound a call today to learn more about the GE Vscan Extend Dual Probe. We have knowledgeable people who will be happy to answer all your questions and help you decide what equipment you need for your office. Talk to one of ultrasound specialist today.