RUSH protocol: Rapid Ultrasound for Shock and Hypotension

Patients with hypotension or shock have high mortality rates, and traditional physical exam techniques can be misleading. Diagnosis and initial care must be accurate and prompt to optimize patient care. Ultrasound is ideal for the evaluation of critically ill patients in shock, and ACEP guidelines now delineate a new category of ultrasound (US)– “resuscitative.” Bedside US allows for direct visualization of pathology and differentiation of shock states.

The RUSH Protocol was first introduced in 2006 by Weingart SD et al, and later published in 2009. It was designed to be a rapid and easy to perform US protocol (<2 minutes) by most emergency physicians.

How do you perform the RUSH protocol?

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By Salim Rezaie, MD|2019-09-10T13:38:55-07:00Jun 1, 2013|Cardiovascular, Ultrasound|

PV card: Pediatric Assessment Triangle

Have you heard of the Pediatric Assessment Triangle? Taught in the Pediatric Education for Prehospital Professionals (PEPP) certification course, it provides a clear and simple approach to the emergency assessment of pediatric patients. The following PV card summarizes the PAT:

PV Card: Pediatric Assessment Triangle

Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Reference

Dieckmann R, Brownstein D, Gausche-Hill M. The pediatric assessment triangle: a novel approach for the rapid evaluation of children. Pediatr Emerg Care. 2010;26(4):312-315. [PubMed]

By Michelle Reina, MD|2021-10-06T19:54:37-07:00May 30, 2013|ALiEM Cards, Pediatrics|

Out-of-Hospital Cardiac Arrest and Prehospital Intubation

Worldwide, death from cardiac arrest in the out-of-hospital setting remains the leading cause of mortality. Focuses have aimed at improving bystander CPR, public access to AEDs, minimizing chest compression interruptions, and decreasing the emphasis on advanced airway management. This latter concept has become so important that the AHA/ASA have now changed their “ABC” philosophy to “CAB.” Below is the review of the literature that has changed this philosophy.

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By Salim Rezaie, MD|2019-09-10T13:38:46-07:00May 29, 2013|Cardiovascular|

What’s the Code Dose of tPA?

Suppose you have a patient in whom you highly suspect a pulmonary embolism (PE) that devolves into PEA arrest while awaiting a CT angiogram. Or, what about a patient with an ECG showing clear STEMI that loses pulses?

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By Bryan D. Hayes, PharmD, DABAT, FAACT, FASHP|2018-02-17T01:56:47-08:00Mar 14, 2013|Tox & Medications|

Bottom Line ¹

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By Michelle Lin, MD|2016-11-11T18:42:29-08:00Jan 1, 2013|Pulmonary|

Patwari Academy videos: ACLS and post-resuscitation care

This is the last installment of Dr. Rahul Patwari’s digital whiteboard video talks on ACLS, specifically focusing on post-resuscitation care and therapeutic hypothermia.

Parts 1-3 (ACLS and airway)
Parts 4-6 (ACLS: cardiac arrest)
Parts 7-10 (ACLS: bradycardias and tachycardias)

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By Michelle Lin, MD|2016-10-26T17:05:07-07:00Dec 16, 2012|Patwari Videos|