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RUSH Protocol: Rapid Ultrasound for Shock and Hypotension

Infographic by Dr. Jonny Wilkinson @Wilkinsonjonny 

#RUSH #Protocol #Rapid
RUSH Protocol: Rapid ... Wilkinsonjonny #RUSH
BRASH Syndrome

B - Bradycardia
R - Renal failure
A - AV nodal blockade
S - Shock
H - Hyperkalemia

Typical ECG
BRASH Syndrome ... Typical ECG in BRASH ... hyperkalemia) BRASH ... DrEricStrong #BRASH
Rapid Ultrasound in SHock Evaluation
RUSH Protocol:
 • PUMP: LV contractility, RV strain, tamponade
 • TANK: IVC
SHock Evaluation RUSH ... jackcfchong #RUSH
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
phlebotomy High ... Burns • Trauma/Crush ... causes #potassium #high
Causes of Rhabdomyolysis - Differential Diagnosis
 • Drugs & Toxins (Statins, alcohol, cocaine)
 • Direct Muscle
Damage (Trauma/crush
RUSH(ed) Exam - POCUS Protocol
Rapid Ultrasound in Shock and Hypotension
1. Parasternal Long Cardiac View
2. Apical Four-Chamber
RUSH(ed) Exam - ... circumstances #RUSH
Bradycardia - Differential Diagnosis Framework

BRADI Mnemonic
 • BRASH/Hyperkalemia
 • Reduced oxygen/Glucose/Temp
 • ACS
 • Drugs
 •
BRADI Mnemonic • BRASH ... Infections BRASH
Salter Harris Physeal Injury Classification

S - Straight through - Type I - Separation through the physis
A
epiphysis R - cRush
Laboratory Evaluation of Patients for Thyroid Disease 
Hyperthyroidism:
 • Graves disease - TSH low; free T4
TSH low; free T4 high ... and T3 normal or high ... and T3 normal or high ... free T4 and T3 high ... free T4 and T3 high
Hypocalcemia Workup - Differential Diagnosis Algorithm
 • Low Magnesium, High Magnesium - Functional Hypoparathyroidism
 • High
Low Magnesium, High ... Hypoparathyroidism • High ... disorders, HIV • High ... Phosphate, High