RUSH Protocol

The management of shock remains a major clinical challenge—even for experienced clinicians—due to the difficulty in determining its underlying etiology and defining the most appropriate immediate therapy. The complex pathophysiology of shock can render traditional physical examination findings unreliable. The high mortality associated with shock, directly related to the intensity and duration of hypotension, demands rapid and accurate diagnostic assessment and intervention to optimize patient outcomes [1].Bedside ultrasound, particularly the RUSH protocol (Rapid Ultrasound for Shock and Hypotension), has emerged as a standard of care in emergency medicine and critical care for the evaluation of shock states [2].Initially presented as separate ultrasound techniques, RUSH is a relatively new protocol that integrates these components into a streamlined three-step algorithm. Designed for point-of-care application, it was developed to help rapidly identify the etiology of shock or hypotension, proving especially useful for distinguishing obstructive, cardiogenic, and hypovolemic shock [3].More comprehensive and detailed than FAST, the RUSH exam must be performed by a clinician with formal ultrasound training, allowing rapid decision-making in reversible shock states and significantly improving the likelihood of successful resuscitation. Early recognition combined with appropriate treatment has been shown to reduce mortality in critically ill patients [1,2].