Abstract
Clinical assessment and classification of shock is extremely difficult to conduct on critically ill patients especially upon arrival at the emergency department. Resuscitative point-of-care ultrasound could be used for rapid initial diagnosis and better management. In this study, the results of using the RUSH (Rapid Ultrasound in Shock) exam to determine the type of shock in the emergency department are compared to the final diagnosis of patients. This was a single-center prospective study in which all patients with an unknown type of shock and no prior treatment were included. Parallel to the standard resuscitative management and diagnosis of the emergency team, the RUSH exam was performed blindly on the patient by an emergency medicine staff who was not part of the patient’s caregiving team. The results of the RUSH exam were then compared to the final diagnosis of the patients and the 48-h outcome. Twenty-five patients were enrolled in this study. The overall kappa correlation of the RUSH exam compared with the final diagnosis was 0.84 which is an almost perfect agreement. The overall sensitivity of the RUSH exam was 88 % and the specificity was 96 %. Although the mortality rate was 64 %, there was not a significant relationship between mortality and the protocol used for diagnosis. The RUSH exam could be used in emergency wards to detect types of shock.
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Acknowledgments
The authors would like to show their deepest gratitude to those patients who voluntarily participated in this study. The authors would like to appreciate Dr. Hamid Shokoohi, from Gorge Washington University, School of Medicine and Health Sciences, for his helpful comments on this study.
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The authors declare that they have no conflict of interest.
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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
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Bagheri-Hariri, S., Yekesadat, M., Farahmand, S. et al. The impact of using RUSH protocol for diagnosing the type of unknown shock in the emergency department. Emerg Radiol 22, 517–520 (2015). https://doi.org/10.1007/s10140-015-1311-z
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DOI: https://doi.org/10.1007/s10140-015-1311-z