Rapid Ultrasound in Shock (RUSH) Velocity-Time Integral: A Proposal to Expand the RUSH Protocol.
Ultrasound assessment of patients in shock is becoming the standard of care in emergency and critical care settings worldwide. One of the most common protocols used for this assessment is the rapid ultrasound in shock (RUSH) examination. The RUSH protocol is a rapid evaluation of cardiac function, key vascular structures, and likely sources of hypotension. Stroke volume is an established important value to assess in the setting of shock, allowing the provider to predict the patient's response to treatment. However, the calculation of stroke volume or its surrogates is not part of any protocol, including RUSH. We propose the addition of ultrasound calculation of stroke volume or surrogates to the RUSH protocol and provide support for its utility and relative ease of calculation. The resulting product would be the RUSH velocity-time integral protocol.
Intensive Care Unit, Hospital Dr Emilio Ferreyra, Necochea, Argentina 
Pablo
P
Blanco
Intensive Care Unit, Hospital General Santa María del Puerto, El Puerto 
de Santa María, Spain
Francisco Miralles
FM
Aguiar
University of South Carolina School of Medicine, Colombia, South Carolina 
USA and Department of Emergency Medicine, St Francis Hospital, Columbus, 
Georgia USA.mike@blaivas.org
Michael
M
Blaivas
D000465:Algorithms; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D003422:Critical Care / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012769:Shock / Q000150:complications / Q000000981:diagnostic imaging*; D013318:Stroke Volume
point-of-care ultrasound; rapid ultrasound in shock; shock; stroke volume; ultrasound; velocity-time integral