March 26, 2020
Written by: Mark Swanson, RVT, RDMS, RT(R)
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Best Ultrasound Training for the Clinician Treating the Patient with Undifferentiated Hypotension
Providing care to the patient with shock can be one of the most challenging issues in Emergency medicine. Even the most experienced clinician can struggle determining the cause of shock and the most favorable initial therapeutic approach. The traditional physical examination can be misleading given the complex physiology of the Hypotensive patient. Patients in shock have high mortality rates which are correlated to the extent and duration of their hypotension, therefore the diagnosis and initial treatment must be accurate and immediate.
The RUSH exam is a structured point-of-care (POCUS) ultrasound examination for the non-traumatic patient in the emergency department presenting with undifferentiated hypotension. The exam typically starts with the cardiac portion but the clinician’s judgment and the clinical circumstances should lead the progression through the different components of the RUSH exam.
These 3 components include evaluating the PUMP, TANK, and the PIPES. The PUMP is the cardiac examination to determine the presence of pericardial effusion and assessing contractility. The second component is evaluating the TANK to quickly access volume status by determining IVC diameter and variations in size with respiration as well as examining the chest. COVID-19 is a virus that affects the upper respiratory system. Diagnostic Ultrasound can be a valuable tool to rapidly diagnose and treat a variety of lung abnormalities such as pneumonia, lung consolidation, acute respiratory failure, pneumothorax, pleural effusion, and other conditions.
The use of ultrasound can provide a rapid and safe method to improve the time to diagnose and/or treat these patients resulting with increased patient safety, satisfaction, and over-all patient outcomes during this challenging time. The PIPES portion of the RUSH exam involves evaluating the abdominal aorta for the presence of aneurysm or dissection and performing a limited DVT study if clinically indicated.
Where can you get the best ultrasound education in order to immediately begin integrating these skills into clinical practice?
Gulfcoast Ultrasound Institute offers a Blended Introduction to Critical Care and Advanced Emergency Medicine/Critical Care Ultrasound course at its’ education facility located in St. Petersburg, Florida. This course is taught by leading Emergency Medicine / Critical Care Ultrasound experts. The hands-on scanning sessions offer the industry lowest 3:1 faculty to participant hands-on ratio with live models to increase competence to immediately begin to integrate the skills learned into clinical practice.
All Blended Ultrasound Courses are approved to provide AMA PRA Category 1 Credit(s)™ (Other CME Credit types are approved for select courses.) ACCME Accredited with Commendation.
POCUS Certification Academy Education Partner, which means: Tuition includes this course as well as discounted (20%) Point-of-Care Ultrasound (POCUS) Certification Academy assessment/certification fees. This program meets all POCUS Certification Academy exam prerequisites and will provide a peer evaluation case log enabling attendees to immediately sit for the POCUS Certification Examination.
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